HOW DO I PAY FOR ABA?
- Pre-authorization
- We contact your insurance provider to verify coverage for ABA services. If issues arise, we will work with you during the pre-authorization process
- Re-authorization:
- We complete all necessary paperwork and submit it to insurance for every re-authorization period to ensure that your services remain covered.
- Billing:
- We bill your insurance directly and resolve any denied claims
The Steven A. Geller Autism Coverage Act requires health insurance plans to provide coverage to an eligible individual for:
- Well-baby and well-child screening for diagnosing the presence of autism spectrum disorder.
- Treatment of autism spectrum disorder through speech therapy, occupational therapy, physical therapy, and applied behavior analysis.
Coverage for the services shall be limited to $36,000 annually and may not exceed $200,000 in total lifetime benefits for an individual under 18 years of age or an individual 18 years of age or older who is in high school who has been diagnosed as having a developmental disability at 8 years of age or younger.
Citation: Fla. Stat. Ann. §627.6686
DOES INSURANCES COVER ALL SERVICES OFFERED BY SANTIAGO & FRIENDS?
No! Not all services provided by Santiago & Friends are covered by insurance. Some services such as art therapy and social groups may not be covered. Please ask to clarify any coverage for services before appointments are scheduled. You will be responsible for costs.
DOES SANTIAGO & FRIENDS HAVE A PRIVATE PAY RATE?
Santiago & Friends does have an out-of-pocket rate for those individuals who are interested. Our main goal is to keep the cost of services as low as possible, while maintaining the quality of our service.
CAN MEDICAID PAY FOR SERVICES?
Santiago & Friends’ is Medicaid approved! We currently accept Medicaid and CMS.
WHICH INSURANCE COMPANIES ARE SANTIAGO & FRIENDS CURRENTLY IN-NETWORK WITH?
Santiago & Friends currently accepts:
- Blue Cross, Blue Shield New Directions
- Cigna
- Aetna
- Florida Blue
- United Healh (OPTUM) Behavioral Health
- TriCare South
- ChampVA
If your insurance company covers services and we are not currently in-network, please contact Santiago & Friends to expedite our provider status and to address how to begin services.
If your child is 3 years of age through 12th grade with one of the following disabilities: autism, cerebral palsy, Down syndrome, Prader-Willi syndrome, Spina bifida, Williams syndrome, or Intellectual Disability (severe cognitive impairment), or if he or she is deemed “high risk” due to developmental delays, then he or she may qualify for a special scholarship called the Gardiner Scholarship (PLSA) program through the Step Up For Students initiative! Funds from this scholarship can be applied to a variety of services and materials, including therapy. Click on the link to find out more!
We are an approved provider for the Gardiner Scholarship!
Still have questions? Send us an email to [email protected].