Steps to Start Services – Commercial Insurance

We work with families using commercial insurance in two ways: if we’re already in-network with your plan, or through a Single Case Agreement (SCA) when we’re not yet contracted with your specific insurer. Here’s how each path works.

We’re currently in-network with TriCare (East and West), UHC (Optum), Premera Blue Cross (Anthem), and CHAMPVA.

If We’re In-Network With Your Plan

  1. Get a referral from your diagnosing physician.
  2. Call us to verify your insurance benefits. Have your ID number and your child’s and sponsor’s name and date of birth ready, and we’ll verify your ABA coverage directly with your plan.
  3. Schedule your intake (over the phone, typically 30–45 minutes).
  4. Complete your intake.
  5. You’ll receive Consent forms once your intake is complete. Fill these out in their entirety and send them back to us.
  6. Once we have your forms, we request authorization for your initial assessment through your insurance company.
  7. Once your assessment is authorized, we pair you with a BCBA who’s the best fit for your family.
  8. Your BCBA calls to schedule your initial assessment.

If We’re Not In-Network: Single Case Agreements (SCA)

  1. Get a referral from your diagnosing physician.
  2. Reach out to us with your insurance information (ID number, and your child’s and sponsor’s name and date of birth).
  3. We contact your insurer to verify benefits and see whether a Single Case Agreement is possible, or whether your plan will only offer out-of-network benefits. A Single Case Agreement is a one-time agreement where your insurer processes your claims at the in-network rate, and it’s typically only available when there’s no in-network provider in your area.
  4. If an SCA isn’t available, your case manager will walk you through what out-of-network coverage looks like, including an explanation of benefits and your cost-share details.
  5. Schedule your intake (over the phone, typically 30–45 minutes).
  6. Complete your intake. You’ll receive Consent forms before your intake, please fill these out completely and send them back.
  7. Once we have your forms, we request authorization for your initial assessment through your insurance company.
  8. Once your assessment is authorized, we pair you with a BCBA and get your initial assessment scheduled.
  9. Every six months, your case manager works with you and your BCBA to renew your SCA, based on in-network provider availability in your area at that time.

Get Started

Have a question about your specific plan, or ready to take the first step? Call us at (904) 446-0953 or email info@nocalbehavioralservices.com. You can also read our FAQ or view the states we serve.