Spectrum Intake Checklist
Fill out application paperwork and upload all other requested forms. Please check the paperwork checklist before submitting. Other documents needed include the child’s psychological evaluation, IEP from the school (if applicable), updated shot records and a picture of the front and back of your insurance card. Please call us at (940)228-5297 with any issues or if you were not able to submit all paperwork at once.
2. Insurance Verification and Pre-Authorization
- For Tricare: Tricare covers our services. The parent will be responsible for contacting their primary care physician to receive a referral for our services.
- For all other insurance companies: Rose Street Spectrum contacts your insurance to determine if you have coverage for ABA therapy. If insurance does not cover our services, we will contact you immediately to inform you. If a pre-authorization is required by insurance, we will begin that process as soon as we are prepared to begin the process of taking your child as a client.
3. Parent Meeting, Assessment and Financial Meeting
A month or two before services begin, our staff will contact the parents to set up meetings. Parents will have a financial meeting where insurance benefits will be explained and a payment plan contract will be presented. The second meeting will be between the parents and the case manager (BCBA) to discuss what behaviors the parent finds important to work on. The next appointment is in order to determine how many hours of ABA your child needs, the BCBA conducts an in-depth assessment of your child in clinic.
After the assessment, the BCBA writes and submits a report to your insurance carrier and the carrier approves a specific number of hours of service per week for your child. This approval process can take up to 8 weeks. After the authorization of services is approved, the child can be placed on the schedule for the following month.
Your assigned BCBA will develop a treatment plan to be implemented by the ABA paraprofessionals (RBTs), who are under regular supervision. The BCBA will also provide the family with training and support.
Per insurance guidelines: children must have an Autism diagnosis in order for insurance to approve services. If they are not diagnosed already, please take them to a diagnosing psychologist to have a psychological evaluation before proceeding with our application.
Rose Street Spectrum does have a waitlist for services with a typical waiting timeline of 3-6 months. All application paperwork must be turned in before being placed on waitlist.
Insurance we are In-Network with
- Blue Cross Blue Shield
- United Health Care
Please note that not all plans within these insurance carriers will cover ABA therapy.
Medicaid does not currently pay for ABA therapy in Texas but a bill was passed in 2019 for terms to be written. Once those terms are written, we will begin the process to go in-network with Medicaid. We currently have a Medicaid waitlist in anticipation of this, please give us a call to get that process started.