Crossroads ABA Center is an out-of-network provider. Many families use their out-of-network benefits to help cover ABA services, and our team will help you verify your benefits and understand what your plan covers before services begin.
This page explains how out-of-network coverage generally works for ABA therapy, which plans families most often use, and what to ask your insurance company before your child begins care.
What “Out-of-Network” Means
Being out-of-network means Crossroads ABA Center does not hold a direct contract with your insurance company. It does not mean your plan offers no coverage. Many commercial plans include out-of-network benefits that reimburse part of the cost of ABA therapy.
Your financial responsibility is dependent on your specific insurance plan, including its out-of-network deductible, coinsurance and annual out-of-pocket maximum.
Plans Families Commonly Use
We regularly work with families who have coverage through:
- Aetna
- Cigna
- United Healthcare
- Blue Cross Blue Shield
- Anthem
- Independence BCBS
- GEHA
- Meritain Health
- UMR
- Oxford
- Amerihealth
- Amerihealth Administrators
Appearing on this list means we have experience submitting out-of-network claims to that insurer. It does not guarantee coverage for your child — benefits vary from plan to plan, even within the same insurance company.
Single Case Agreements
A Single Case Agreement (SCA) is a temporary, one-time contract between an insurance company and an out-of-network provider that allows the patient to receive care covered at in-network rates when it is not feasible or appropriate to see an in-network provider.
An SCA is sometimes an option when there is no in-network ABA provider with availability in your area. Our intake team can assist with insurance verification and authorization.
Questions to Ask Your Insurance Company
Before your child begins care, it helps to call the member services number on your insurance card and ask:
- Does my plan cover applied behavior analysis (ABA) for an autism spectrum disorder diagnosis?
- Do I have out-of-network benefits for ABA, and what percentage of the cost is reimbursed?
- What is my out-of-network deductible, and how much of it has been met this year?
- Is prior authorization required before services begin?
- Is there an annual limit on the number of visits or hours?
- Will my plan consider a Single Case Agreement if no in-network provider is available?
Having your member ID and your child’s diagnosis information to hand will make the call faster.
Getting Started
If you have questions about coverage, contact our team or call (609) 804-5863. We can review your insurance information with you, explain what the verification process involves, and talk through the next steps for beginning care.
Frequently Asked Questions
Does being out-of-network mean my insurance will not cover anything?
Not necessarily. Out-of-network means we do not hold a direct contract with your insurance company, but many commercial plans still reimburse a portion of out-of-network care. What you pay depends on your plan’s out-of-network benefits, deductible and coinsurance.
How do I find out what my out-of-network benefits are?
Call the member services number on the back of your insurance card and ask specifically about out-of-network coverage for applied behavior analysis. The questions further up this page cover what to ask. Our intake team can also help you work through it.
Is a diagnosis required for insurance to cover ABA therapy?
A diagnosis of autism spectrum disorder (ASD) is typically required for insurance to cover ABA therapy. If your child does not yet have a diagnosis, our team can talk through what the process usually involves.
Is prior authorization needed before services begin?
Many plans require prior authorization for ABA therapy, and some also require periodic reauthorization as treatment continues. Requirements vary by plan. Our intake team can assist with insurance verification and authorization.