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ABA Agency



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amother
OP


 

Post Tue, Dec 03 2019, 5:12 pm
I'm just starting down the path of ABA for my child. Which agency in Boro Park did you use? Were you happy? I'm debating between Encore and Yeled Vyalda.

Thanks!
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cholenteater




 
 
    
 

Post Tue, Dec 03 2019, 5:37 pm
What age is your child? Do you need Yiddish or English speaking providers? What type of personality does your child have- do you need more rigorous structure or more of a natural teaching environment?
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flowerpower




 
 
    
 

Post Tue, Dec 03 2019, 5:39 pm
Make sure that the therapist is well trained and knows what she is doing. That is the main!
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cholenteater




 
 
    
 

Post Tue, Dec 03 2019, 5:40 pm
Another thing- are you paying insurance premiums or does your current insurance cover ABA? If you will be paying premiums, pm me and I can give you a number if someone who assists with getting medicaid waiver to cover insurance premiums. I also can highly recommend a specific BCBA who works at Encore. She is an excellent supervisor and really makes sure the provider is trained. Feel free to pm me directly if you feel comfortable, or I can set up an anonymous email.
Another thing you can do is reach out to Project Menucha for support and guidance into the world of extra programs.
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amother
OP


 

Post Tue, Dec 03 2019, 6:39 pm
cholenteater wrote:
What age is your child? Do you need Yiddish or English speaking providers? What type of personality does your child have- do you need more rigorous structure or more of a natural teaching environment?


He's 6.5. I guess it can be either Yiddish or English. I don't know what type would work for him. He's very rigid. I would assume he needs a more natural teaching environment to balance it out?
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amother
OP


 

Post Tue, Dec 03 2019, 6:44 pm
cholenteater wrote:
Another thing- are you paying insurance premiums or does your current insurance cover ABA? If you will be paying premiums, pm me and I can give you a number if someone who assists with getting medicaid waiver to cover insurance premiums. I also can highly recommend a specific BCBA who works at Encore. She is an excellent supervisor and really makes sure the provider is trained. Feel free to pm me directly if you feel comfortable, or I can set up an anonymous email.
Another thing you can do is reach out to Project Menucha for support and guidance into the world of extra programs.


I'm told that Child Health Plus covers ABA fully. We pay a small monthly fee for it.

Another thing is that I was told by one agency that I'd need to see a psychologist to administer the ADOS test so that we can get an autism diagnosis in order to get ABA services. We had the test done today (and paid $400 for it.) I happened to call the 2nd agency to find out more about health insurance options and was told that some pediatricians can write a letter stating that he's on the spectrum and this would work for some insurance companies. Is that true?
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cholenteater




 
 
    
 

Post Tue, Dec 03 2019, 6:59 pm
amother [ OP ] wrote:
I'm told that Child Health Plus covers ABA fully. We pay a small monthly fee for it.

Another thing is that I was told by one agency that I'd need to see a psychologist to administer the ADOS test so that we can get an autism diagnosis in order to get ABA services. We had the test done today (and paid $400 for it.) I happened to call the 2nd agency to find out more about health insurance options and was told that some pediatricians can write a letter stating that he's on the spectrum and this would work for some insurance companies. Is that true?


It depends on which child health plus plan you have, there are different brackets.
I am sorry that you paid out of pocket, there are psychologists who are covered under your insurance that can administer the test. Yes the wait time may be a few weeks so perhaps it was easier for you to pay out pocket.
Yes, some insurances (such as Oscar, Empire and UHC) will accept a letter by the pediatrician. I have had families that it has gone through, and some that do not and then they go for further testing. I have heard it is getting harder to get letter approval though.
So perhaps the 1st agency just wanted to go straight to the test, and the second agency was willing to do more paperwork, se it goes through and if not request testing. This may be possible that the second agency was willing to try in order to help make it more financially feasible and save you time.
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amother
Magenta


 

Post Tue, Dec 03 2019, 8:14 pm
Does Medicaid pay for aba?
If we have united healthcare thr Medicaid does it cover? When do you need to get private insurance? How do you get Medicaid to pay the premiums?
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amother
Azure


 

Post Tue, Dec 03 2019, 9:31 pm
Encore
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cholenteater




 
 
    
 

Post Tue, Dec 03 2019, 9:41 pm
amother [ Magenta ] wrote:
Does Medicaid pay for aba?
If we have united healthcare thr Medicaid does it cover? When do you need to get private insurance? How do you get Medicaid to pay the premiums?

Currently Medicaid does not pay for ABA services however it was recently put into the budget by law, so hopefully it will be placed into effect soon! That will be a huge help to parents!
Depending on which plan of UHC, majority of plans do cover. If you are looking to get ABA services and do not have coverage under your current plan, you would need to purchase a secondary plan through the NYS insurance market place. The open enrollment period started in November and ends January 31.
There are ways to get medicaid to pay for premiums, you need to fill out forms and justify the cost- showing Medicaid that is actually cheaper for them to pay the premiums and use the secondary insurance for the neurologist, specialists, Drs and so on. If you pm me I can share a number of someone who does the legwork and processing for a fee.
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amother
OP


 

Post Thu, Jan 02 2020, 8:31 am
I submitted all the ABA paperwork to an agency in BP. I called my contact a few days later to ask her when she expects to receive approval from the health insurance co. No call back. I emailed her twice. No response. Is this in any way ok? (Imagine me at work not responding to a client. Surprised )
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cholenteater




 
 
    
 

Post Thu, Jan 02 2020, 8:53 am
amother [ OP ] wrote:
I submitted all the ABA paperwork to an agency in BP. I called my contact a few days later to ask her when she expects to receive approval from the health insurance co. No call back. I emailed her twice. No response. Is this in any way ok? (Imagine me at work not responding to a client. Surprised )

That is not the usual way it goes, perhaps there will be a delay of 1-2 days but you should have received a response that they had received your paperwork. They may not have an answer of approval, but there should still be open communication of where the process is at.
When did you submit it though? This past week was holiday break for many people, with Chanuka, then xmas and new years....
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amother
OP


 

Post Thu, Jan 02 2020, 9:20 am
Around 2 weeks ago. I don't need the approval. Just a response as to what the expected wait time is. I'm desperate to get help and I feel like I'm in the hands of an incompetent high school graduate. I guess I'll wait till tomorrow before I call again.
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