Tricare & Private Insurance

ASN, who has been an industry leader in the field of Applied Behavior Analysis for over a decade, is excited to work closely with Tricare. ASN is contracted to provide Tricare services in all three regions in the US. Tricare has developed two models in the delivery of ABA Therapy for its members; each has advantages.

The two programs are 1) Enhanced Access to Autism Services Demonstration Project and 2) Interim Benefit.

1. Enhanced Access to Autism Services Demonstration Project

•  Advantages
•  Easy access and more therapy hours are delivered through the use of:
•  Trained paraprofessionals (tutors)
•  Tutors are supervised by a BCBA
•  Live video conferencing is available, thus increasing therapy hours and access
•  Disadvantages

2. Interim Benefit

•  Advantages
•  Falls under Tricare medical benefit
•  Both active duty and retired personnel have access
•  Tricare Basic financial caps apply
•  Out of pocket expenses paid for ABA Therapy will be reimbursed back to Feb 16th, 2010 in the US and Feb 16th, 2008 for overseas.

•  Disadvantages
•  Services can only be delivered by a Board Certified Behavior Analyst (BCBA). There are so few BCBAs in the country that access to therapy and adequate therapy hours can be difficult to achieve.
•  BCBAs are not allowed to video conference in order to increase access or therapy hours
•  Because the Interim Benefit is the result of a recent court decision, it is likely to be modified soon due to the appeal process.

Private Insurance

If you should leave the military of are no longer eligible for Tricare and have private insurance ASN/ Pacific Child and Family Associates likely can continue to offer you services. We have listed the carriers we are currently contracted with below but if your insurance carrier is not listed, do not lose hope, we may still be able to provide services. In many cases, insurance carriers will allow us to treat your child on a case by case basis. PCFA can help you understand the steps you need to follow to request services and we are recognized providers of ABA and related services for the following carriers:

ABA Services
•  Aetna
•  Anthem Blue Cross/Wellpoint
•  Blue Cross
•  Blue Cross Blue Shield
•  CIGNA Behavioral Health
•  Dept. Human Srvs-MN Health Care Program (DHS-MHCP)
•  Healthnet / Managed Health Network (MHN) (ASG)
•  Itasca Medical Care (I.M. Care)
•  Lovelace Health Plan
•  Magellan Behavioral Health
•  Medicaid
•  Minnesota Dept. Human Services
•  MultiPlan
•  TriCare North/MHN
•  TriCare South
•  TriCare West
•  United Behavioral Health (UBH)

Ancillary Services

•  Anthem Blue Cross/Wellpoint
•  Beech Street
•  Blue Shield of California/TriCare West
•  Cal-Optima Direct (PPO)
•  Evolutions (PPO)
•  First Heath (PPO)
•  Fortified (PPO)
•  Galaxy (PPO)
•  Great West (PPO)
•  Health Network America (PPO)
•  Integrated Health (PPO)
•  Memorial Care/Bristol Park (HMO)
•  Monarch Cal-Optima (HMO)
•  Monarch HealthCare (HMO)
•  MultiPlan/BCE (PPO)
•  National Preferred Provider Network (PPO)
•  Provider Select (PPO)
•  RockPort HealthCare Group (PPO)
•  St. Joseph Heritage Heathcare (HMO)
•  Three Rivers (PPO)
•  TLC Advantage (PPO)
•  United HealthCare (PPO)

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