What to be vigilant about with insurance-based ABA Companies
What are insurance-based ABA companies? They are ABA companies that provider services to families who are eligible to receive behavior intervention services under their insurance due to a diagnosis of their child. Below, are just some of the facts and information that may assist you if you have ever had services from a company.
Insurance-based ABA Companies are typically dictated by what insurance is willing to pay for. Insurance however, can limit some of the quality services that may be necessary for a family to receive. This can include (but not excluded to): in depth behavior technician trainings, team meetings outside of session to communicate, or additional admin work such as creating content and resources for families. Most of you already know what the pro’s are to receiving ABA services from an insurance-based company (just read the companies motto!), however most will not tell you the possible side effects of behind-the-scene operations from the employee or company perspective. If you have been a victim of an ABA company or worse, traumatized by the lack-of-quality of one, below are some important notes that might help:
• It is important to note that insurance providers who decide what services are billable to insurance by the ABA companies are not educated, trained, or necessarily well versed in the field of applied behavior analysis
• Insurance providers expect an X number of programs to be run at the same time, oftentimes this could be up to 30+ programs being run simultaneously in one session by the behavior technician. It is important to ask, is this something you are okay with? Does this set your child up for success?
• Insurance companies require an assessment and goals that stem from those assessments. The problem with that is while assessments can be helpful, not every individual needs one (much less 30+ programs) to be successful. Ask yourself, Are all these goals relevant and socially valid for your child? If utilized for the wrong reasons, this can set the entire ABA team (including the client) up for failure or trauma.
• It is important to note that many individuals may be more motivated by the compensation aspect than maintaining top notch quality services. That may mean ABA companies are not willing to pay out of pocket for their employees for important aspects of quality service such as in-depth training, meetings outside of sessions, and additional administrative time when needed. If they did, they would lose money. This leaves their employee’s (BCBA’s/RBT’s) less motivated and uncompensated, which may result in high turnover rate. Furthermore, this creates a toxic dynamic of untrained therapists and BCBA’s who are not held accountable for possible unethical decisions or actions that are being implemented with a client.
• Many ABA companies get stuck in a cycle of accepting more families/clients before they have hired enough RBT/BCBA’s for these families. That means either the family gets their hopes up by the company only to go several months without services, or there is high turnover rate from the company due to the urgency to hire, and the family can go through as many as 3-4 different RBT’s/BCBA’s within a 6 month period, This can result in frustration and a bad experience with the ABA field, making long term support for their child become unattainable, or potential for trauma if the behavior technician is not adequately trained due to the urgent need for staff by the company.
• Insurance providers require company staff to check mark “communication and social skill deficits and repetitive and restrictive behaviors” (since this is considered part of the diagnosis) in order to submit notes. There is a current shift where many individuals see those with autism (and other diagnosed labels) as individuals who are wired differently and learn differently, rather than having skill deficits or restrictive behaviors-because this directly affects how we perceive the services we offer. For families or trending BCBA’s in the field who do not possess these traditional beliefs about individuals with autism, you need to ask, what does this say about the company or staff who are following insurance protocols such as these?
This does not mean that all insurance-based ABA companies approach services like this, although it may be difficult to find a quality company. Receiving quality services from an insurance-based ABA company is going to depend on many factors: the individuals who take your caseload (not necessarily the company) and their training experience, the values of the company (and if they actually follow those values), how the company compensates and treats their employee’s, and so much more. Furthermore, having the ability to receive free behavior intervention services for families who cannot afford it is as a service is very necessary. At the end of the day, the conclusion should not to veer away from insurance-based companies, but to be vigilant, do your research, ask questions, and reach out for advocacy services when you aren’t certain if you are receiving quality services. Please refer to my advocacy services to learn more.