Insurance Coverage
Health insurance can be confusing. Our team works with Medicaid, private insurance, and many employer-sponsored plans to check benefits, obtain authorizations, and explain any out-of-pocket costs so your child can access ABA services when covered. We handle the paperwork and coordination so you can focus on your child's progress.
Helping Families Navigate ABA Therapy Coverage
Many health plans— including numerous Medicaid programs and commercial policies—cover ABA therapy for children diagnosed with autism when medically necessary. Coverage varies by state, plan type, and whether the plan is self-funded, and prior authorization is often required. At Knowledge Road, we explain your options, confirm eligibility, and help you use the benefits available to your family.
Our goal is to take the stress out of insurance so you don't have to manage it alone.
With this service, we provide:
- Initial benefits verification for ABA therapy
- Prior-authorization support and submission of required documentation
- A clear review of deductibles, co-pays, coinsurance, and any plan limits
- Ongoing help with renewals, appeals, and coverage questions
- Guidance on in-network benefits and state-specific rules
This service is designed to:
- Confirm whether ABA is covered under your plan
- Clarify potential costs before services begin
- Reduce delays by managing approvals and follow-up
- Support appeals if coverage is denied
- Help families make the most of their benefits
Why This Service Matters
Insurance is a common barrier to starting therapy. By working directly with health plans and providers, we help families understand their benefits, avoid avoidable delays, and begin services as soon as coverage allows.
Verify Your Insurance Coverage
We'll contact you to verify benefits and explain your options.
Service Overview
Families with coverage through Medicaid, private insurance, or employer-sponsored plans.
All coordination handled virtually or by phone.
Benefit checks and authorizations are often completed within 1–3 business days, depending on the plan.
No cost for insurance verification; when covered, ABA services are billed to your insurance provider.
What Families Receive
- A dedicated insurance specialist to manage the process
- A written breakdown of coverage and estimated costs
- Support with prior authorizations and renewals
- Appeals assistance if coverage is denied
- Ongoing answers to insurance-related questions
Who This Is For
Families seeking ABA services who want to confirm insurance coverage, understand costs, and streamline approvals.
Verify Your CoverageFrequently Asked Questions
Common questions about insurance coverage for ABA therapy and how we can help navigate the process.
How do I know if my insurance covers ABA therapy?
Many plans cover ABA for autism; specifics depend on your state, plan type (including whether it's self-funded), medical-necessity criteria, and authorizations. We contact your insurer to verify benefits and explain what's covered under your policy.
What if my insurance claim is denied?
We guide families through the appeals process—gathering documentation, coordinating letters from your healthcare provider, and submitting a comprehensive appeal to the insurer.
Do you accept Medicaid?
We participate with Medicaid in the locations where we are enrolled as providers. Medicaid coverage for ABA varies by state; many states cover ABA for children with autism, often under EPSDT (for children under 21). We'll confirm eligibility and any cost-sharing for your specific plan.
Ready to Verify Your Coverage?
Contact us to learn more about Insurance Coverage assistance and how our specialists can help you navigate the approval process for ABA therapy services.