Built for ABA Therapy Providers
Long-term care needs long-term coverage clarity.
ABA is some of the longest-running treatment in healthcare. Coveragence keeps eligibility, authorizations, and payer rules aligned across years of care — so your clinical team never loses authorized hours.
Book a demo
See how it works
THE ABA REALITY
Multi-year care meets ever-shifting payer rules.
Authorizations expire, plans switch, mandates evolve. Manually tracking it all across hundreds of clients is impossible.
Multi-year auth lifecycles
Initial assessments, treatment plans, 6-month renewals, and concurrent reviews stack up across years per client.
State autism mandates
Every state mandate is different — and commercial, Medicaid, and TRICARE rules layer on top of each other.
Place-of-service rules
Center-based, home-based, and telehealth ABA all have different billing rules and coverage limits per payer.
Parent-training billing
Parent training, supervision, and direct-treatment codes each have their own auth rules and frequency limits.
Concurrent review burden
Reviewers demand fresh medical-necessity documentation every renewal cycle — most of which already lives in the EHR.
Plan churn during care
Families change plans through job changes, Medicaid renewals, and CHIP transitions — silently breaking coverage.
HOW COVERAGENCE HELPS
An eligibility and authorization layer built for ABA.
Coveragence brings autism mandates, payer rules, and authorization renewals into one continuously updated workspace.
Eligibility built for ABA
Verify autism mandate coverage, hour limits, and prior-auth requirements across commercial, Medicaid, and TRICARE plans automatically.
→ Eligibility Engine
Authorization renewal tracking
Surface upcoming reauth deadlines, document gaps, and concurrent-review triggers before authorized hours run out.
→ Auth Tracker
Mandate & rules database
Built-in coverage of autism mandates, BCBA supervision rules, and place-of-service requirements — kept current as states change them.
→ Payer Database
Daily plan-change alerts
Catch employer plan changes, Medicaid renewal lapses, and MCO shifts the day they happen — not at the end-of-month claims run.
→ Coverage Monitor
The outcomes ABA providers see.
94%
Reauthorizations secured before expiration.
47%
Fewer hours billed against expired auths.
$3.1M
Annual revenue protected per 100-client panel.
Start making your life easier with Coveragence
