How to refer a family for ABA Therapy
A referral to iCare Therapy needs three things and takes one call, one fax or one form. This page lists the three things, states the two routes, describes exactly what happens to the family in the first week, and says what the referring practice will hear back and when. It ends with a one page guide designed to be printed and kept by the phone.
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What we need to accept a referral
First, the diagnostic report that established the autism spectrum diagnosis. If it is not yet finalized, refer anyway and say so, because iCare Therapy can begin verifying insurance and speaking with the family while the report is completed. Second, the family’s insurance information, ideally an image of both sides of the card. Third, a contact for the family, with their consent to be contacted by iCare Therapy. That is the complete list. Anything the plan later asks for, iCare Therapy obtains itself.
What is not needed: a specific referral form, a treatment recommendation, an hours request, or a letter of medical necessity. If a practice has any of those they are welcome, but their absence does not delay a referral. The single most common cause of a slow start is a practice waiting to assemble a perfect packet before sending anything. Send what you have and say what is coming.
Which families to think of first
Any family with an autism spectrum diagnosis and a home in the service area can be referred, and iCare Therapy will speak with all of them. Some families, though, are more likely to succeed with in-home care than with the clinic based alternatives, and a referring practice is usually the person best placed to recognize them. The family without reliable transport. The family with two working parents and no room in the week for a drive across town three times. The family whose child has tried a clinic and did not transfer the skills home. The family in Statesville or Mooresville or Belmont for whom the nearest clinic is a county away. The family who is already overwhelmed and for whom one more thing to get to would be the thing that stops therapy.
None of that is a claim that in-home care is superior. It is a description of which families it fits, so that a practice can refer with a clear picture of what the family is being sent to.
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How to submit it
By fax to the referral line, by phone to the direct provider number, or through the referral form. The direct line reaches a person who handles referrals and does not sit behind the parent intake queue. A clinician calling on behalf of a family should never reach a voicemail asking about a diagnosis.
The referral form asks for exactly the three items above and nothing else. It is short on purpose.
What happens in the family's first week
Within one business day, iCare Therapy contacts the family. The first conversation is listening rather than paperwork: what the family sees at home, what they hope changes, what their week looks like. Then benefits are verified, so that the family knows what is covered and what their share is before they commit to anything. Then the authorization request is assembled from the diagnostic report and iCare Therapy’s own intake, and submitted to the plan.
For Mecklenburg families on Medicaid with behavioral health needs, that plan is usually Alliance Health. For Iredell and Gaston families, it is Vaya Partners. iCare Therapy works both routes and requests authorization on the family’s behalf; neither the family nor the practice needs to call the plan. If the plan needs anything further, iCare Therapy obtains it directly. When authorization arrives, an assessment with a Board Certified Behavior Analyst is scheduled, and therapy begins after that assessment.
iCare Therapy does not promise a start date at any point in this process, because the plan’s side of it is not within anyone’s control. What it does is tell the family, and the practice, exactly which step the referral is at and what is being done about it.
What the family will be told
It helps a practice to know what a family will hear from iCare Therapy, so that the two conversations match. The family will hear that therapy is delivered at home by a Registered Behavior Technician and supervised by a Board Certified Behavior Analyst who writes the plan around their child. They will hear that iCare Therapy accepts North Carolina Medicaid and most major insurers, that benefits are verified before anything begins, and that iCare Therapy requests the authorization. They will not hear a start date, a timeline or an outcome promise, and they will not hear a medication, a school, a district or a program named. If a practice tells a family the same things, nothing surprises anyone later.
What the referring practice hears back, and when
Three notifications, without the practice having to ask. Confirmation that the referral was received, on the day it arrives. Confirmation that the family was reached, within one business day. Notification when therapy begins. If a family cannot be reached after reasonable attempts, or declines, or falls outside the service area, the practice hears that too, so that nobody assumes a family is in care who is not.
Practices tell us that this is the part most providers omit, and it is the reason this section exists. A referral that disappears into silence is a referral the practice stops making. iCare Therapy would rather earn the next one.
Sharing progress after therapy begins
With the family’s written consent, iCare Therapy will share goals and progress data with the referring practice, on request rather than only on a schedule. A referring clinician who wants to know how a family is doing three months in should be able to ask and get an answer with data behind it. Nothing moves without the family’s consent, and iCare Therapy will tell the practice plainly when consent has not been given rather than leaving the request unanswered.
The one page guide
Below this section is a one page referral guide, designed to be printed and kept by the phone. It carries the three requirements, the two contact routes, and the three notifications the practice will receive. Nothing else.
