Health Insurance Coverage for Autism - Acorn Health

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Insurance Costs and Considerations

The range of clinical and insurance information needed to qualify for and receive ABA services can be daunting, but our admissions team works with families to verify insurance coverage, provide an overview of financial commitments, and help create plans and lessen surprises along the path to receiving ABA therapy. We accept most major insurance carriers, but ABA benefit coverage can vary. Please contact us for assistance in verifying your individual coverage and to discuss considerations.

Client Experience Team

Acorn Health's Client Experience Team is here to simplify the path to beginning ABA therapy.

We can provide assistance in the following areas:

Financial Concierge Services

Our team assists you in identifying individual policy benefits and ABA services coverage included in your plan. This may include seeking additional financial coverage from specialty programs you may qualify for based on individual circumstances.

Extended Financial Assistance

We work with families so that your child can receive the ABA services they need while considering flexible payment options in regards to insurance deductibles and/or co- pays. We assist with creating individual payment plans that work with you, not against you.

Eligibility & Claims

We provide ongoing verification of insurance plans and coverage, including Medicaid in states where it’s accepted, to ensure your coverage remains active throughout the time your child is receiving services.

Get in touch

For questions regarding financial responsibility and assistance, invoices, or to make a payment, contact our Client Experience Team by calling (844) 854-1116 ext. 566# or email us at clientexperience@acornhealth.com.

Board-certified ABA services

To get started on verifying your individual coverage and benefits, call admissions today.
(844) 244-1818.

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Frequently asked questions

At Acorn Health, we understand how overwhelming an autism spectrum diagnosis can be for a family. It’s our goal to make this step in finding treatment options for your child as straightforward as possible and provide you with the clarity you need to make the right decisions for your family. Here you will find answers to some of the most common questions families ask us about ABA therapy, as well as what you can expect at Acorn Health.

Explore FAQs

  • What is ABA therapy?

    ABA is an acronym for “Applied Behavior Analysis,” an intensive behavioral therapy that focuses on learning how behaviors change, how they are affected by the environment, as well as has how learning takes place. The goal of ABA therapy as an autism therapy program is to increase desirable behaviors and reduce behaviors that interfere with an individual’s ability to learn. Acorn Health looks to establish and enhance socially important behaviors & improve an individual’s quality of life by providing and transferring critical knowledge, skills, and abilities. Areas that are explored include:
    • Family Training
    • Social Skills Training
    • Communication Training
    • Toilet Training
    • Feeding Therapy
    • Vocational Training
    • Functional Living Skills/Activities of Daily Living
    • Direct Instruction

  • How do I know if ABA therapy is right for my child?

    The only person who can decide if ABA therapy is right for your child is you. The Acorn Health team recommends discussing this with your child’s pediatrician and other specialists who are involved in your child’s health care or education. It is worth noting that Applied Behavior Analysis (ABA) methods are data-driven and have been studied for decades. ABA is endorsed by the US Surgeon General, the American Psychological Association, Autism Speaks, and dozens of other leading research, medical, and advocacy organizations. ABA therapy covers a wide array of skill sets so it’s best to communicate which skills you believe as a parent should be prioritized during initial treatment planning and throughout the treatment process.

  • What is an ABA Assessment?

    An ABA assessment is not a diagnostic assessment, rather it is a time utilized to observe and work with a child to determine what their unique needs are. There is also a detailed parent interview included in the assessment to learn about your child’s behaviors at home, in school, and any other environment in which your child spends time. The assessment is scheduled once a family completes the registration process and is informed that there is availability to start therapy. Once the assessment is completed, Acorn Health staff creates a treatment plan and therapy program which is reviewed and approved by the family. ABA assessments are conducted regularly (typically every six months or so) to make program adjustments as your child continues to make progress and meet his or her therapy goals.

  • How often will my child need therapy?

    Since ABA is most effective when it is intensive, the recommended hours for this type of therapy generally fall between 10 to 40 hours per week depending on the specific needs of your child. Very rarely is there a situation where under 10 hours is effective. The number of recommended hours for your child will be determined by our clinical team after your child’s assessment when the treatment plan is developed.

  • Is there an age limit for our ABA therapy?

    Acorn Health typically serves children between 18 months and 21 years of age. Medicaid stops covering ABA at age 21, and most major commercial insurances stop between the ages of 18 to 21.

  • Is family training available?

    Acorn Health’s program includes a weekly family training component where the family meets with the BCBA to learn to implement interventions, summarize progress, and discuss any concerns about treatment or additional behavioral issues. We have found this collaborative approach with families to be one of the most effective steps in the therapy process.

  • How do I know if my therapist is the right match for my child?

    Acorn Health’s BCBAs undergo intensive training and continue to have bi-weekly clinical meetings. The organization’s approach is collaborative, which makes us a leader in the field of ABA services. When assigning therapists to clients, we do our best to match skill sets and personalities. If there are specific qualifications you are looking for in a therapist, please be sure to discuss that during the clinical consult and before starting services so we can keep that in mind as we onboard your family.

  • Where does ABA therapy take place?

    We offer center-based, home-based, and some in-school therapy services. We will work with you to recommend a setting that will aid in your child’s development and therapy. Center-based autism therapy has additional benefits that can be important, including access to peers, a more controlled environment, novel toys and items, and routines that could help with school integration in the future. We typically offer home-based services if you live within 15 - 20 miles of one of our centers. In some communities this is extended, so please contact us to find out if we have home-based services in your area. We do offer in-school services in select communities. The school policy must allow for outside services to be present, and your insurance company must also cover school-based services. Your BCBA may recommend starting with a home or center-based model first before determining if school is a clinically recommended setting for services.

  • What is an ABA Assessment?

    An ABA assessment is not a diagnostic assessment, rather it is a time utilized to observe and work with a child to determine what their unique needs are. There is also a detailed parent interview included in the assessment to learn about your child’s behaviors at home, in school, and any other environment in which your child spends time. The assessment is scheduled once a family completes the registration process and is informed that there is availability to start therapy. Once the assessment is completed, Acorn Health staff creates a treatment plan and therapy program which is reviewed and approved by the family. ABA assessments are conducted regularly (typically every six months or so) to make program adjustments as your child continues to make progress and meet his or her therapy goals.

  • What does the initial process to get started look like?

    Below are the initial steps you can expect before your child begins therapy:
    1. Conduct an initial conversation with our Admissions team
    2. Verify insurance coverage for ABA
    3. Schedule a Clinical Director Consult (if desired)
    4. Request authorization for an initial assessment from the insurance company
    5. Schedule and complete an initial assessment for your child
    6. Provide assessment results to the insurance company and request ongoing treatment coverage
    7. Coordinate a start date for therapy Because there are several parts of the process, we recommend getting started right away. We are here to help you navigate the process and make it as streamlined as possible.

  • Where can I get my child diagnosed?

    Your insurance company is always the best resource to get information on where to complete an autism assessment and to see what’s covered in-network, and your child’s pediatrician is also a valuable authority to ask where to obtain a diagnosis locally. Many psychologists, neurologists, and developmental pediatricians have the expertise and training to provide an autism diagnosis. By contacting Acorn Health when your child has an Autism diagnosis, you can begin the process of ABA therapy. The sooner your child begins services, the sooner interventions can make an impact on their growth and learning trajectory. * Acorn Health is now providing diagnostic services in the Michigan area only under a licensed and credentialed psychologist and BCBA, Dr. Greg Worthington. This service is available in Grand Rapids, Gaylord, Cadillac, and Traverse City. Please contact us directly for more information.

  • How do you determine availability for my child? How long is the typical waiting period?

    Generally, three factors are utilized to determine availability:
    • The family and child’s schedules
    • The location of service/center of choice
    • The expected number of clinically appropriate hours of therapy
    After obtaining this information, Acorn Health can identify if there is immediate availability for your child. We review our availability weekly and work to try and accommodate interested clients at our locations by adding more staff where we are able. Additionally, we have recently added locations across the United States to meet the demand of families who need our services. If you have questions about any of our locations, please contact us.

  • What insurance plans do you accept? Do you take Medicaid?

    We are in contract with many commercial insurance companies, and we also accept Medicaid in some states, but our contracts do vary state-by-state. Please contact our Admissions team directly for us to review your specific insurance plan and check for ABA therapy coverage. See our Insurance Costs and Considerations page to learn more.

  • What is the cost of therapy? What will my out-of-pocket expenses be?

    Acorn Health assists families with a courtesy call to insurance companies to obtain a summary of benefits. During this call, we check if there is ABA coverage included in the child’s insurance plan. If ABA coverage is applicable, the team will provide you with an estimate of copays, deductibles, and out-of-pocket maximums related to your specific insurance plan. However, to better understand coverages, it’s encouraged that families speak directly with their insurance provider. If ABA coverage is not applicable, it’s advised that families consider an insurance plan that has ABA coverage, or we can offer private pay as an alternative option. Acorn Health can only bill insurance if the child is medically diagnosed with ASD or if ABA is deemed ‘medically necessary’. If you are seeking to pay out of pocket, the admissions manager can provide you with private pay rates.

  • How often will my child need therapy?

    Since ABA is most effective when it is intensive, the recommended hours for this type of therapy generally fall between 10 to 40 hours per week depending on the specific needs of your child. Very rarely is there a situation where under 10 hours is effective. The number of recommended hours for your child will be determined by our clinical team after your child’s assessment when the treatment plan is developed.

  • How is Acorn Health different?

    Acorn Health is the pioneering ABA therapy provider for families of children and adolescents with an Autism Spectrum Disorder (ASD) seeking behavioral therapy services. As a standard-setting quality provider of Applied Behavior Analysis services, Acorn Health has been recognized as a “Behavioral Health Center of Excellence,” a highly recognized industry accreditation that includes rigorous standards, such as how well the provider collaborates with other support therapies, quality of staff training, parent satisfaction surveys, success involving parents in therapy processes, and more. Acorn Health is also a member of the Council of Autism Service Providers (CASP), a non-profit organization committed to evidence-based care in the treatment of Autism. Together, courageous families and ABA clinicians help children develop their strengths, so they may lead their most independent, meaningful lives. The provider’s teams have superior clinical & administrative leadership that instills a culture of caring for families and abides by a strict code of ethics to ensure the best care for all families. Services include:
    • Provides individualized, age-appropriate learning objectives
    • Provides one–on–one therapy, initially in a clinical center or in-home, and then generalized to other settings, including school
    • Provides continuous training and support to parents throughout services
    • Provides support to the child, family, teachers, and administrators during the child’s transition to school
    • Board Certified Behavior Analysts (BCBAs) provide weekly supervision
    • Provides service coordination with other specialists such as OT, SLP, etc.
    • Family Training is a priority, ensuring families are actively involved in programming for their child

  • Is family training available?

    Acorn Health’s program includes a weekly family training component where the family meets with the BCBA to learn to implement interventions, summarize progress, and discuss any concerns about treatment or additional behavioral issues. We have found this collaborative approach with families to be one of the most effective steps in the therapy process.

  • What qualifications do your therapists and clinicians have?

    Each child’s therapy team is led by a board-certified, master’s or doctoral trained and credentialed BCBA. Our clinicians are always up to date on evidence-based practices and work as a team to provide the best treatment for the children in their care. They strive to think outside the box to provide your child with individualized programming that is meaningful to your family. In addition to their formal education, training, and credentials, our new employees undergo 40 to 60 hours of additional training at Acorn to prepare, which includes online learning, role play, shadowing, and didactic learning opportunities. Our Registered Behavior Technicians (RBTs) are an important part of our treatment teams, providing direct therapy under the supervision of the BCBA. Before starting with clients, all technicians go through an approximately 40 – 65 hour training program as well as an intensive job shadowing process. When they are ready, they sit for the national exam to become RBTs.

  • How do I know if my therapist is the right match for my child?

    Acorn Health’s BCBAs undergo intensive training and continue to have bi-weekly clinical meetings. The organization’s approach is collaborative, which makes us a leader in the field of ABA services. When assigning therapists to clients, we do our best to match skill sets and personalities. If there are specific qualifications you are looking for in a therapist, please be sure to discuss that during the clinical consult and before starting services so we can keep that in mind as we onboard your family.

  • Where does ABA therapy take place?

    We offer center-based, home-based, and some in-school therapy services. We will work with you to recommend a setting that will aid in your child’s development and therapy. Center-based autism therapy has additional benefits that can be important, including access to peers, a more controlled environment, novel toys and items, and routines that could help with school integration in the future. We typically offer home-based services if you live within 15 - 20 miles of one of our centers. In some communities this is extended, so please contact us to find out if we have home-based services in your area. We do offer in-school services in select communities. The school policy must allow for outside services to be present, and your insurance company must also cover school-based services. Your BCBA may recommend starting with a home or center-based model first before determining if school is a clinically recommended setting for services.

  • Can I take a tour of the center?

    Absolutely, the Acorn Health team would be happy to schedule a tour for you at any of the center-based ABA therapy locations. We cannot accept walk-in tours due to the safety and privacy of our staff and clients, but please contact us to discuss a scheduled tour.

  • What are your hours? Do you offer services on weekends?

    Typically, services will be conducted between the hours of 8 AM to 7 PM on weekdays. Weekend hours are also available to accommodate family schedules at many locations.

  • How do you handle therapists leaving? How much notice will I get?

    The Acorn Health team does its best to minimize disruptions to services due to changes in staffing; however, disruptions occur at times. When this is true, it's an expectation that families receive clear and frequent communication from our staff about the next steps. Acorn Health prioritizes telling parents of any changes to their child’s treatment well in advance (a minimum of two weeks when possible). In the event of this transition, the team ensures that newly assigned staff is quickly brought up to speed and has adequate training prior to assuming treatment responsibilities.

  • Does Acorn Health provide translation services or accommodations for those with Limited English Proficiency (LEP)?

    Acorn Health provides translation services to ensure that persons with Limited English Proficiency (LEP) have meaningful access and an equal opportunity to participate in our services, activities, programs and other benefits. The policy of Acorn Health is to ensure meaningful communication with LEP clients and their authorized representatives involving their medical conditions and treatment.

  • Does Acorn Health foster a diverse, equitable, and inclusive environment for all?

    At Acorn Health, we are committed to fostering a diverse, equitable, and inclusive environment for all. From recruitment and retention efforts to our marketing and admissions processes and communications, we strive to reflect the communities we serve. We integrate diversity into our practices and strive to create a culture of inclusivity that listens to, values, and incorporates the unique perspectives, experiences, and backgrounds of all staff and clients. We work to ensure that all team members feel safe, respected, and valued in their work environments. We believe that by prioritizing diversity, equity and inclusion throughout Acorn Health, we can build an environment that truly celebrates everyone who is employed by or receives care from our organization. We believe that a culture of inclusion and equity not only benefits our team but also increases the quality of services we provide to our clients. We are committed to providing culturally responsive applied behavior analysis (ABA) services that meet the needs of all clients regardless of race, ethnicity, gender identity, sexual orientation, age, religion, or ability. True to our core value of growth, we recognize that fostering an inclusive environment requires continuous learning and commitment. We regularly evaluate our policies, practices, and procedures to identify areas for improvement and take steps to address any shortcomings.