Frequently Asked Questions

What is Applied Behavior Analysis?

Applied Behavior Analysis (ABA) is the only scientifically validated intervention for treating autism. (ABA) applies the principles of learning and motivation to manage challenging behaviors and increase functional skill development.

A comprehensive ABA program will address a variety of skill deficits and challenges your child is having. Each treatment plan is individualized based on your child’s strengths and deficits. Treatment plans commonly address language and communication skills, social and play skills, adaptive living skills, and reduction of challenging behavior.

ABA is an evidence-based approach and is widely recognized as a safe and effective treatment of Autism Spectrum Disorder.

What is TeleBehavioral Health?

TeleBehavioral Health is delivery of health related services and information via telecommunication technologies. Behavior Change Institute utilizes a secure, HIPAA compliant Electronic Health Record System to facilitate communication between families, BCI Clinicians, as well as collaborate with other professionals in the families support team (e.g., SLP, PT, OT). Through this state-of-the art system, families can access:

  •      Treatment Records
  •      Clinical Correspondence
  •      Treatment Schedule

Is there research to Support TeleBehavioral Health?

Yes! Behavior Change Institute only uses evidence-based methods to assess and treat children on with Autism Spectrum Disorder. In fact, at Behavior Change Institute, we use evidence based methodologies throughout all areas of our practice, including staff training and organization management.

Why TeleBehavioral Health?

According to the World Health Organization, the geographical location of a family is one of the main contributing factors as to whether an individual with a disability will receive access to treatment. As such, many individuals with disabilities living in rural or geographically isolated areas continue to be underserved.

At Behavior change Institute, our mission is to increase access and build capacity so families can access medically necessary services for their children.

Is there a provider on-site?

Absolutely! The team working with each family consists of a Supervising Clinician (BCBA/BCaBA) and Behavior Technician(s). A Behavior Technician renders services directly with the child in their home and/or community. Each week, the child’s supervising Clinician (i.e., BCBA) observes a session in real-time, either in-person or a secure video streaming program. During this time, the Clinician observes the Behavior Technician implementing the child’s treatment protocol. This allows BCI to monitor progress and modify treatment protocols on a weekly basis, as well as ensure the Behavior Technician’s fidelity of implementation of the treatment plan (i.e., delivering treatment as it is written).

Where are your ABA providers located?

Our ABA providers are currently supporting children and families throughout the state of New Mexico and Texas. Using our advanced tele-health technology, we have the ability to serve families in even the most remote locations.

Does BCI accept insurance?

Yes, BCI participates with a number of private health insurance companies as well as the New Mexico state Medicaid program. We are currently in-network and accepting clients under the following health plans:

Alaska

  • Beacon Health Options
  • Premera Blue Cross of Alaska
  • Tricare
  • United Healthcare

New Mexico Medicaid (Centennial Care)

  • Molina Healthcare
  • Presbyterian Health Plan
  • Blue Cross Blue Shield of New Mexico
  • United Healthcare Community Plan
  • Western Sky Community Care (Coming January 2019)

New Mexico Commercial Health Plans

  • Molina Healthcare
  • Presbyterian Health plan
  • Blue Cross Blue Shield of New Mexico
  • United Healthcare
  • Christus Health Plan
  • Tricare

Texas Health Plans

  • Tricare

Oftentimes, if we do not participate in a family’s health plan, we can still obtain the authorizations required to provide service at an in-network benefit level (managing out of pocket expenses for the family). If we are not in-network with the family’s health plan, we can at the very least offer a complimentary eligibility review to explore options for coverage. In every case, please ask the family to sign our event sign-in sheet and our Care Coordinator will follow-up directly.

What is the difference between fully funded and self-insured?

A fully-insured health plan is the more traditional way to structure an employer-sponsored health plan. With a fully-insured health plan

  • The company pays a premium to the insurance carrier
  • The insurance carrier collects the premiums and pays the health care claims based on the coverage benefits outlined in the policy purchased
  • The covered persons (employees and dependents are responsible to pay any deductible or copayments required for covered services under the policy
  • Fully-insured plans are regulated at the STATE level (*state autism mandates apply in most cases)

Under self-insured health plans, employers (usually larger) operate their own health plan as opposed to purchasing a fully-insured plan from an insurance carrier. Employers choose to self-insure because it allows them to save the profit margin that an insurance company adds to its premium for a fully-insured plan. However, self-insuring exposes the company to a much larger risk in the event that more claims than expected must be paid. With a self-funded plan:

  • Employers contract a Third Party Administrator to administer health benefits for employees
  • Employers pay claims directly
  • Self-insured plans are regulated at the FEDERAL level (*state autism mandates do not apply)
  • Many employers offering self-funded benefits have opted for autism coverage (although it’s not required)

What options are available to a family with a self-insured health plan that excludes coverage of ASD Treatment?

  • Purchase individual plan on state exchange
  • Enroll in state Medicaid plan (if eligible & state Medicaid plan includes ABA)
  • Approach employer group (HR Department) – BCI should provide family with Autism Speaks Toolkit for Self-Insured.

What is the cost of treatment?

The cost of treatment is entirely dependent on coverage under the health plan.  Standard to our intake process is a complimentary eligibility review, through which BCI will contact the family’s health plan to obtain details of coverage and out-of-pocket expenses.

Will you provide services outside of my home?

Absolutely yes! We feel that it is imperative to conduct observation and assessment services across environments in order to understand the effect of environment on behavior, which will enable us to develop a comprehensive treatment plan.  Services can be conducted in a variety of settings including daycare, school and the community.

Does BCI work with individuals who do not have a diagnosis of autism spectrum disorder (e.g., ADD, ADHD, Emotional Impairment, etc.)?

While the principles of ABA can be effectively applied to all human behavior, our health insurance partners currently limit coverage of ABA therapy to individuals diagnosed with autism spectrum disorder.

What is your eligibility criteria?

  • Must have a diagnosis of Autism Spectrum Disorder and a written recommendation or prescription for ABA treatment
  • If the child has not yet received a diagnosis, BCI is always willing to support the family by way of referral (to local diagnostician)

How many Behavior Technicians are on a treatment team?

Typically, each child is assigned one or two Behavior Technicians, depending on the intensity of treatment (# of hours per week).