Initial assessment

Process for completing initial assessment

Humana Military follows a placement process to ensure beneficiaries have access to an Applied Behavior Analysis (ABA) provider within TRICARE’s access to care standards.

How the process works:

• Humana Military will contact the ABA providers to inquire about availability for the initial assessment and treatment
• Humana Military will assign a provider that meets the criteria for accepting a new referral (the provider placement process does not replace parent/caregiver choice)
• The parent/caregiver should contact the assigned ABA provider to schedule the first visit with the beneficiary and complete the initial assessment

What to expect during an assessment

The initial assessment may involve multiple visits and includes a direct observation of the beneficiary needing care. Information will be collected to help develop an individualized treatment plan which will include treatment recommendations and goals.

The assessment includes:

• Background information
• A Functional Behavior Assessment (FBA)
• Completion and review of the parent/caregiver interview and parent report rating scales
• The development of a treatment plan including the Individual Education Plan (IEP) for children receiving ABA services in a public or private school setting
• Completion and review of outcome measures
• Parent/caregiver agreement on treatment plan

Getting a second opinion

The beneficiary can obtain a second opinion from a different ABA provider if requested. A new referral is not required as long as it is within the two-year timeline.

Two “ongoing” treatment authorizations of direct service are not permitted. It is important to communicate with Humana Military on which provider the beneficiary would like to use to avoid delays in authorization approval for treatment.