Getting Started with Services
Congratulations, you’ve taken the first step in getting quality services for your family! But what happens now? Check out our helpful videos and charts so you know what to expect every step of the way.
Insurance & Billing FAQs
Have questions about insurance and other payers? You’re in the right place!
Does insurance cover ABA therapy?
Yes! Most insurance plans in New Jersey cover ABA therapy for individuals with an autism diagnosis. State law requires many plans to include this coverage. Because every plan is different, our team completes a free verification of benefits (VOB) to confirm your benefits, share estimated costs, and explain your options before you begin.
Do you accept Medicaid or DDD?
Yes. We accept Medicaid HMOs and DDD funding for eligible clients. Medicaid covers clinic-based ABA, while in-home ABA is available for adults through DDD. We can review your eligibility and help you understand which services and locations qualify.
Are you in-network with insurance companies?
Graham Behavior Services is an out-of-network provider. Many families still receive partial reimbursement through their out-of-network benefits, and we handle insurance billing directly to simplify the process for you.
What does out-of-network mean?
Out-of-network means we are not directly contracted with your insurance company. Your plan may still reimburse part of the cost after applying deductibles or co-insurance. We’ll help you understand what your plan allows and what your financial responsibility will be.
Why is Graham Behavior Services out-of-network?
Operating out-of-network allows us to:
- Maintain smaller caseloads so BCBAs can spend more time supervising and collaborating
- Offer competitive pay to attract and retain experienced clinicians
- Provide consistent care with stable clinical teams
This model prioritizes quality, consistency, and individualized care.
How much does ABA therapy cost?
Costs depend on your insurance coverage, plan type, and the amount of therapy recommended. Because New Jersey law requires many insurance plans to cover ABA therapy, your out-of-pocket costs are often limited to deductibles and co-insurance. We review all details during your verification of benefits so there are no surprises.
How does billing work at Graham Behavior Services?
We take care of billing for you. Claims are submitted directly to your insurance, processed, and then reviewed through an Explanation of Benefits (EOB). You’ll only receive a bill for your portion after insurance has completed payment. If insurance sends you a check directly, our billing team will guide you on how to send it to us.
What is a verification of benefits (VOB)?
A verification of benefits is when our team contacts your insurance company to:
- Confirm whether ABA therapy is covered
- Review your deductible, co-insurance, and out-of-pocket maximum
- Estimate your financial responsibility
This helps you understand costs before starting services.
What is balance billing?
Balance billing can occur with out-of-network providers.
Insurance sets an “allowed amount” for each service. If that amount is lower than the provider’s rate, the difference may become the patient’s responsibility.
At Graham Behavior Services, balance billing is only applied when necessary and is capped at our private pay rates. Our team will review this with you in advance if it applies to your plan.
How long does insurance take to process claims?
Insurance processing typically takes 30–45 days, sometimes longer.
The process looks like this:
- Services are provided
- Claims are submitted
- Insurance reviews and processes the claim
- An Explanation of Benefits (EOB) is issued
- You are billed for any remaining balance
What happens if insurance sends me a check?
Sometimes insurance sends reimbursement checks directly to families.
If this happens:
- The check is for services already provided
- You will need to sign it over to Graham Behavior Services
- Our billing team will guide you through the process
This is called assignment of benefits.
