✦ Now Welcoming Families · Private Pay & Out-of-Network Support · English & Russian
Private Pay
Pay at time of service. No prior authorization, no waitlist, no insurance delays. Start within 2–3 weeks of your first call.
Out-of-Network Support
We help verify your benefits, assist with prior authorization requirements, and provide superbills for reimbursement.
In-Network Insurance
Credentialing underway. Enrolled families are notified immediately when their insurer approves us. Same BCBA, same goals.
Private Pay
Pay at time of service. No prior authorization, no waitlist, no insurance delays. Start within 2–3 weeks of your first call.
Out-of-Network Support
We help verify your benefits, assist with prior authorization requirements, and provide superbills for reimbursement.
In-Network Insurance
Credentialing underway. Enrolled families are notified immediately when their insurer approves us. Same BCBA, same goals.
Private Pay
Pay at time of service. No prior authorization, no waitlist, no insurance delays. Start within 2–3 weeks of your first call.
Out-of-Network Support
We help verify your benefits, assist with prior authorization requirements, and provide superbills for reimbursement.
In-Network Insurance
Credentialing underway. Enrolled families are notified immediately when their insurer approves us. Same BCBA, same goals.
How Our OON Process Works
Scroll For Steps
Complete the secure OON benefits form
After the brief consultation, provide policy details and secure images of the insurance card through the separate OON form. This verifies benefits only and is not the full client onboarding packet.
We verify benefits and report back
Within 1–2 business days after receiving the OON form, we contact the insurer and report the deductible, reimbursement terms, authorization requirements, and estimated family responsibility. Insurance information is not a guarantee of payment.
We prepare required documentation
After the assessment and with your written authorization, we assist with the required clinical documentation. Out-of-network authorization is not guaranteed, but families may choose to begin services through private pay if coverage is denied.
You submit superbills monthly & receive reimbursement
Upon request, we provide a complete superbill for you to submit through your insurer’s member portal. Your insurer will process the claim and determine any eligible reimbursement based on your plan.
How Our OON Process Works
Scroll For Steps
Complete the secure OON benefits form
After the brief consultation, provide policy details and secure images of the insurance card through the separate OON form. This verifies benefits only and is not the full client onboarding packet.
We verify benefits and report back
Within 1–2 business days after receiving the OON form, we contact the insurer and report the deductible, reimbursement terms, authorization requirements, and estimated family responsibility. Insurance information is not a guarantee of payment.
We prepare required documentation
After the assessment and with your written authorization, we assist with the required clinical documentation. Out-of-network authorization is not guaranteed, but families may choose to begin services through private pay if coverage is denied.
You submit superbills monthly & receive reimbursement
Upon request, we provide a complete superbill for you to submit through your insurer’s member portal. Your insurer will process the claim and determine any eligible reimbursement based on your plan.
How Our OON Process Works
Scroll For Steps
Complete the secure OON benefits form
After the brief consultation, provide policy details and secure images of the insurance card through the separate OON form. This verifies benefits only and is not the full client onboarding packet.
We verify benefits and report back
Within 1–2 business days after receiving the OON form, we contact the insurer and report the deductible, reimbursement terms, authorization requirements, and estimated family responsibility. Insurance information is not a guarantee of payment.
We prepare required documentation
After the assessment and with your written authorization, we assist with the required clinical documentation. Out-of-network authorization is not guaranteed, but families may choose to begin services through private pay if coverage is denied.
You submit superbills monthly & receive reimbursement
Upon request, we provide a complete superbill for you to submit through your insurer’s member portal. Your insurer will process the claim and determine any eligible reimbursement based on your plan.
What to ask your insurer before our first call
Do I have out-of-network benefits for ABA therapy (CPT 97155 and 97156)?
What is my OON deductible and how much has been met?
What percentage of billed charges does my plan reimburse after the deductible?
Does my plan require pre-authorization before OON ABA claims are reimbursed?
What to ask your insurer before our first call
Do I have out-of-network benefits for ABA therapy (CPT 97155 and 97156)?
What is my OON deductible and how much has been met?
What percentage of billed charges does my plan reimburse after the deductible?
Does my plan require pre-authorization before OON ABA claims are reimbursed?
What to ask your insurer before our first call
Do I have out-of-network benefits for ABA therapy (CPT 97155 and 97156)?
What is my OON deductible and how much has been met?
What percentage of billed charges does my plan reimburse after the deductible?
Does my plan require pre-authorization before OON ABA claims are reimbursed?
Credentialing with:
What is a superbill?
A superbill is a detailed clinical receipt containing everything your insurer needs to process an OON reimbursement claim, your provider's NPI, credentials, CPT code, diagnosis code, date of service, and fee charged.
What is a superbill?
A superbill is a detailed clinical receipt containing everything your insurer needs to process an OON reimbursement claim, your provider's NPI, credentials, CPT code, diagnosis code, date of service, and fee charged.
Credentialing with:
What is a superbill?
A superbill is a detailed clinical receipt containing everything your insurer needs to process an OON reimbursement claim, your provider's NPI, credentials, CPT code, diagnosis code, date of service, and fee charged.
Credentialing with:
Simple, automatic, and stress-free
A quick overview of how payment works once you're a GEMS family, no surprises, no monthly invoices to chase down.
Card on File
A credit or debit card is kept securely on file for every family, collected during intake through our HIPAA-compliant client portal.
Payment is processed automatically on the day of each session, nothing to remember, no invoices to track, no balance that builds up over time.
If you're billing out-of-network, your superbill is generated automatically after payment so you can submit for reimbursement
Cancellations & No-Shows
Life happens, please give us at least 24 hours notice to cancel or reschedule whenever possible.
Sessions cancelled with less than 24 hours notice, or missed without notice, will be charged to the card on file at the full session rate. This protects the consistency of your child's program and the time reserved for your family.
We're always understanding of true emergencies, if something comes up, just reach out and let's talk
Simple, automatic,
and stress-free
A quick overview of how payment works once you're a GEMS family, no surprises, no monthly invoices to chase down.
Card on File
A credit or debit card is kept securely on file for every family, collected during intake through our HIPAA-compliant client portal.
Payment is processed automatically on the day of each session, nothing to remember, no invoices to track, no balance that builds up over time.
If you're billing out-of-network, your superbill is generated automatically after payment so you can submit for reimbursement
Cancellations & No-Shows
Life happens, please give us at least 24 hours notice to cancel or reschedule whenever possible.
Sessions cancelled with less than 24 hours notice, or missed without notice, will be charged to the card on file at the full session rate. This protects the consistency of your child's program and the time reserved for your family.
We're always understanding of true emergencies, if something comes up, just reach out and let's talk
Simple, automatic, and stress-free
A quick overview of how payment works once you're a GEMS family, no surprises, no monthly invoices to chase down.
Card on File
A credit or debit card is kept securely on file for every family, collected during intake through our HIPAA-compliant client portal.
Payment is processed automatically on the day of each session, nothing to remember, no invoices to track, no balance that builds up over time.
If you're billing out-of-network, your superbill is generated automatically after payment so you can submit for reimbursement
Cancellations & No-Shows
Life happens, please give us at least 24 hours notice to cancel or reschedule whenever possible.
Sessions cancelled with less than 24 hours notice, or missed without notice, will be charged to the card on file at the full session rate. This protects the consistency of your child's program and the time reserved for your family.
We're always understanding of true emergencies, if something comes up, just reach out and let's talk