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Fidelis Care Coverage for ABA Therapy
True Progress Therapy proudly accepts Fidelis Care Insurance for ABA therapy services!
Your child's path to personalized ABA therapy is just a step away. Contact us now to verify your coverage and begin services!
Applied Behavior Analysis (ABA) therapy is a highly effective, evidence-based treatment designed to help individuals with Autism Spectrum Disorder (ASD) thrive. At True Progress Therapy, we are proud to support families by offering ABA therapy services tailored to their needs—and we’re excited to welcome Fidelis Care members! With Fidelis Care’s coverage options and our personalized care, achieving progress has never been more accessible.
Yes, Fidelis Care provides coverage for ABA therapy, and True Progress Therapy makes it easy for Fidelis Care members to access our services. We work closely with Fidelis Care to maximize your benefits so you can focus on what matters most—your loved one’s development. ABA therapy is typically included as part of Fidelis Care’s behavioral health benefits for individuals with a formal Autism Spectrum Disorder diagnosis.
Several factors can impact Fidelis Care’s coverage for ABA therapy, including:
State Mandates
New York requires insurance providers, including Fidelis Care, to cover ABA therapy for individuals with ASD. True Progress Therapy ensures compliance with these regulations so you receive the coverage you deserve.
Policy Type
Coverage may vary depending on whether you have an employer-sponsored plan, Medicaid, or an individual policy. Our team will review your specific plan details for you.
Diagnosis Requirement
Fidelis Care typically requires a formal ASD diagnosis for ABA therapy approval. Our experts can assist you through this process if needed.
Medical Necessity
Coverage often depends on demonstrating the medical necessity of ABA therapy. At True Progress Therapy, we collaborate with Fidelis Care to submit all required documentation.
Fidelis Care’s coverage for ABA therapy is designed to provide comprehensive support for individuals with Autism Spectrum Disorder. Your benefits may cover:
Initial Assessments and Evaluations
Skilled clinicians assess your child’s unique needs and create a customized treatment plan tailored to their goals.
One-on-One Therapy Sessions
Individualized sessions with highly trained professionals, including Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs), to help build essential skills and address behavioral challenges.
Parent and Caregiver Training
True Progress Therapy offers guidance to parents and caregivers, empowering them to reinforce therapy strategies at home for consistent progress.
Ongoing Progress Monitoring
Regular assessments ensure your child’s treatment plan remains effective, adjusting goals and techniques as needed to optimize results.
Treatment Plan Reviews and Updates
Fidelis Care requires periodic updates to ensure therapy remains medically necessary and aligned with your child’s needs. True Progress Therapy handles these reviews seamlessly.
While coverage specifics depend on your Fidelis Care plan, True Progress Therapy works closely with Fidelis Care to ensure all required documentation is submitted and benefits are maximized. Our goal is to provide a smooth experience so your family can focus on meaningful progress.
We make the process simple and stress-free for Fidelis Care members. Here’s how:
- Insurance Verification: Our team handles all the legwork of verifying your Fidelis Care benefits and explaining your coverage.
- Personalized Plans: After an ASD diagnosis, we create a customized treatment plan that meets Fidelis Care’s approval requirements.
- Preauthorization Assistance: Many Fidelis Care plans require preauthorization, and we manage the submission process to ensure timely approvals.
- Ongoing Support: We maintain regular communication with Fidelis Care to keep your therapy plan up-to-date and ensure continuous coverage.
True Progress Therapy is committed to minimizing costs for families. Here’s what you need to know about potential expenses:
- In-Network Savings: As an in-network provider for Fidelis Care, we help you maximize your benefits.
- Clear Cost Estimates: We provide transparent cost breakdowns, so there are no surprises.
- Flexible Payment Options: If any out-of-pocket costs arise, we offer payment plans to fit your budget.
As a Fidelis Care member, accessing ABA therapy has never been easier. Contact True Progress Therapy to:
- Verify your Fidelis Care benefits.
- Schedule an initial assessment.
- Begin your personalized ABA therapy journey.
Our compassionate team is here to support you every step of the way. Call us now to learn more about how we can help your family achieve true progress!
FAQs about Fidelis Care ABA Coverage
How do I know if my Fidelis Care plan includes ABA therapy benefits?
True Progress Therapy offers a free insurance verification service to confirm your plan’s ABA therapy benefits. Our team will review your policy, explain your coverage, and guide you through the next steps.
What documentation does Fidelis Care require to approve ABA therapy?
Fidelis Care typically requires a formal diagnosis of Autism Spectrum Disorder (ASD) and a treatment plan demonstrating the medical necessity of ABA therapy. True Progress Therapy assists in gathering and submitting all necessary paperwork to streamline the approval process.
Are there out-of-pocket costs for ABA therapy with Fidelis Care insurance?
True Progress Therapy helps minimize out-of-pocket expenses as an in-network provider for Fidelis Care. However, costs may vary depending on your deductible, copays, or coinsurance. We provide precise cost estimates to help you plan accordingly.
Does Fidelis Care require preauthorization for ABA therapy?
Yes, many Fidelis Care plans require preauthorization for ABA therapy. True Progress Therapy handles this process for you, ensuring all requirements are met and approval is obtained before treatment begins.
What should I do if my ABA therapy claim is denied?
If your ABA therapy claim is denied, first review the denial notice to understand the reason. Contact Fidelis Care’s customer service for clarification and to discuss possible next steps. You can also file an appeal with Fidelis Care, providing additional documentation or information supporting the medical necessity of the therapy.
What options are available if Fidelis Care does not cover ABA therapy under my plan?
If Fidelis Care doesn’t cover ABA therapy, you can appeal the decision, pay out-of-pocket, or explore flexible payment plans. State assistance programs, grants, and scholarships may also help. Additionally, check for benefits through other insurance plans or family members’ policies. True Progress Therapy can guide you through these options to ensure your child receives the care needed.