Request Services

Request Services

We want to thank you for the trust you have in Kid Centered Therapy and would be honored to work with you and your family.

ABA Therapy Intake Form

5-Star Experience
Mom and kids reading

Requirements

The following steps are required for authorization from all insurance companies for ABA services:

  • Completed intake form, including signed consent forms.
  • Prescription for ABA therapy with ICD-10 Code within the last year.
  • Copy/Picture of your health insurance card (front and back)
  • Any previous ABA treatment records you may have If your child is in school, please send us the IEP or 504 plan
  • Current clinically relevant information supporting diagnoses. Comprehensive Diagnostic evaluations must be sent to our intake department prior to authorization of services.
5-Star Experience

After receiving a copy of your insurance card for verification, we will verify benefits and inform you of coverage and any limitations, (if applicable), copays, etc.

Once we have all the required documentation, we will submit to your insurance company for assessment request/admission. Once the insurance company approves admissions, our experienced Board-Certified Behavior Analyst (BCBA) will set up an appointment for an initial behavior assessment with your child. During the Initial assessment, our BCBA will conduct a thorough assessment and observation. A detailed and individualized treatment plan will be developed for your child and then subsequently submitted to insurance for authorization of recommended service hours of therapy.

Once again, the intake team at Kid Centered Therapy is here to walk you through all the steps to ensure that it is a smooth process. Please do not hesitate to contact a member of our intake team or clinical team with any questions.

Start Your Journey Today

Fill out our intake form to request services.