Independence Blue Cross (IBX) now manages all autism case management services in-house for IBX and Independence Administrators members, including applied behavior analysis (ABA).
Providers should work directly with the IBX Case Management team, which includes dedicated case managers and care navigators who coordinate ABA services and related care management support — helping members and families navigate autism-related services before and after an autism diagnosis.
This work supports our mission to promote whole-person health through access to high-quality care and integrated case management services.
What providers should do
- To request ABA services, use one of the following ABA prior authorization forms:
- Fax completed forms and supporting documentation to 215-238-2500.
- Contact the Autism Case Management team with ABA-related questions, for care coordination, or to direct eligible members and families with autism-related support.
- When billing for ABA services, please ensure the primary diagnosis on the claim aligns with the member's documented autism spectrum disorder (ASD) diagnosis and matches the diagnosis submitted on the ABA authorization request. Claims submitted with incorrect or unsupported diagnosis codes may be denied or experience payment delays.
How the Autism Case Management team can help
The Autism Case Management team is a specialized, multidisciplinary team that provides care management support to members and providers for ASD, including ABA. The team includes:
- Autism Care Navigators: Assist with benefit verification, eligibility, authorizations, referrals for autism-related services and connection to care.
- Autism Case Managers: Coordinate care for complex medical and behavioral needs to support a comprehensive, integrated approach to autism care.
- Board Certified Behavior Analyst (BCBA) Care Managers: Review authorization requests and collaborate with providers on care management using evidence-based interventions.
The team can also help members and families locate in-network providers, coordinate services across medical, behavioral health, speech, occupational, and physical therapy providers, and connect with specialty care and community resources.
Questions?
Contact the Autism Case Management team Monday through Friday from 8 a.m. to 6 p.m.:
- IBX: 1-800-688-1911
- Independence Administrators: 1-800-778-2119
For more information about ABA services, refer to the Behavioral Health section of the Provider Manual, which is currently being updated to include additional information.
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