Obtaining insurance authorization for applied behavior analysis (ABA) services has become a routine job expectation for many board certified behavior analysts (BCBAs). Navigating insurance authorizations can be daunting for BCBAs because it requires them to write goals that align with medical necessity and each funder’s unique requirements. Failure to write goals in this manor can lead to partial or full denials for authorization for services, resulting in less access to care for clients. This presentation will focus on understanding funder-specific requirements for ABA services, tying the core deficits of autism to those requirements, and writing treatment goals that are individualized to the client and that are likely to be authorized by funders. We will review how to write goals for activities of daily living, practical functional assessment and skills-based treatment, and leisure skills. Participants will be guided through case examples and practice describing medical necessity, writing treatment goals, and requesting authorization for services from funders.

Learning Objectives

1. Articulate the core deficits of autism
2. Find and interpret funder requirements
3. Describe how to write goals and collect data that algins with funder requirements

About the Presenter

Kara LaCroix

Dr. Kara LaCroix is a Board Certified Behavior Analyst (BCBA) and Licensed Applied Behavior Analyst in the state of Massachusetts. She started her career in 2011 by providing direct care in public school settings before transitioning to home- and clinic-based Applied Behavior Analysis (ABA) services. Kara serves as chief clinical officer at TACT and co-found of Seasons Behavioral Services, located in Massachusetts. Kara received her masters in special education and applied behavior analysis from Endicott college and received her doctorate in behavior analysis from Western New England University under the advisement of Dr. Greg Hanley. Kara’s work focuses on the practical functional assessment and skill-based treatment of problem behavior, as well as preventing the development of problem behavior in young children with Autism. Kara specializes in early intensive behavioral intervention, specifically with the design of programming to increase communication, play skills, and social skills. She has designed interventions that focus on building strong rapport between child and therapist, interventions that build upon their current preferences and skills, and interventions that focus on learning through play.