Insurance
Making Care Easier to Access
Understanding insurance coverage can feel overwhelming. Our team is here to help you navigate benefits, authorization requirements, and the next steps toward starting services.
Tila Promise Pediatric Health works with families across Colorado to make the insurance and intake process as clear and supportive as possible.
We Work With Insurance
We work with a variety of insurance plans and funding sources. Request a consultation to verify benefits and understand the steps needed to begin services.
Understanding Your Costs
Even when services are covered by insurance, families may be responsible for part of the cost.
Possible expenses may include:
- Deductibles
- Copayments
- Coinsurance
- Non-covered services
- Services provided before authorization
- Services exceeding plan limits
- Charges resulting from inactive or changed coverage
Your insurance provider determines your benefits and financial responsibility. We encourage families to contact their insurance company directly with questions about plan-specific costs.
Our team will share available information as clearly as possible before services begin.
Medicaid Coverage
Colorado Medicaid may provide coverage for medically necessary ABA therapy and related behavioral health services when eligibility and clinical requirements are met.
Coverage may depend on several factors, including:
- Active Medicaid enrollment
- The child’s diagnosis and clinical needs
- Provider network participation
- A referral or prescription, when required
- Prior authorization
- Continued medical necessity
- Ongoing treatment-plan reviews
Our team can help families understand what documentation may be needed and guide them through the next steps.
Private Insurance Coverage
Many private insurance plans include benefits for ABA therapy and pediatric behavioral health services. Coverage varies between plans, even when families have the same insurance company.
Your benefits may depend on:
- Whether Tila Promise is in-network with your plan
- Your deductible and out-of-pocket responsibility
- Copay or coinsurance requirements
- Prior authorization rules
- Documentation and referral requirements
- Limits related to services, hours, or settings
- Medical-necessity criteria
We recommend verifying benefits before beginning services. Our team can assist with this process but cannot guarantee payment or coverage from an insurance provider.
Authorization Process
Share Your Insurance Information
Complete our secure insurance verification form and provide the information needed to review your plan.
Benefits Are Reviewed
Our team reviews available benefit information, network status, deductible requirements, and authorization rules.
Insurance verification is an estimate of benefits and is not a guarantee of payment.
Complete the Intake Process
We gather the clinical, referral, and family information needed to determine whether services may be appropriate.
Assessment and Treatment Recommendations
When appropriate, a qualified clinician completes an assessment and develops individualized treatment recommendations.
Authorization Is Submitted
Required clinical documentation is submitted to the insurance provider for review.
The insurance company determines whether services are authorized and may approve a specific number of hours or service period.
Services Begin
Once eligibility, intake, clinical recommendations, and required authorizations are complete, our team works with your family to coordinate scheduling and begin services.
Contact TIla Promise Today
Let’s Support Your Child Together.
We’re here to help your family take the next step with clarity, compassion, and confidence.