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Partners HealthCare ABA Therapy Coverage in North Carolina

One Less Thing To Deal With

Your child needs support. You need a team that shows up consistently and knows what they’re doing. And you need someone who’ll make sure Partners HealthCare doesn’t become another obstacle between your family and real progress.

What Kennedy ABA does with your Partners HealthCare plan:
  • Verify benefits before your first appointment
  • Submit authorizations and handle follow-ups
  • Manage claims, reauthorizations, and appeals
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How we work with Partners HealthCare

Kennedy ABA manages the insurance process so you don’t spend hours learning billing codes and authorization requirements just to access the care your child needs.

Here’s What We Do:
We verify first
Give us your Partners HealthCare information, and we'll confirm exactly what's covered before you commit to treatment. No mid-therapy surprises about what Partners HealthCare will or won't pay for.
We submit authorization requests
Partners HealthCare won't approve ABA therapy without prior authorization. We know exactly what documentation they need, how they want it formatted, and who to follow up with when they go silent.
We break down your costs
Before your child's first therapy session, you'll know what Partners HealthCare pays and what comes out of your pocket. Real numbers based on your actual plan—not ballpark estimates that turn into billing problems later.
We handle the administrative chaos
Submitting claims to Partners HealthCare, following up when on the paperwork, resubmitting when they request more information, appealing when they deny coverage they should approve—we manage it all.
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Insurance Management

Our in Network of Insurance Providers in North Carolina

We work with all major insurance providers across North Carolina:

Don’t see yours? We might work with them, too. Just ask

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We tackle challenges and transform
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What Partners HealthCare covers for ABA therapy

When insurance approves ABA therapy, here’s what’s usually covered:

In-Home ABA Therapy

Direct one-on-one sessions with a trained RBT in your home. Where your child works on communication during actual conversations, practices behavior regulation during real transitions, and builds skills in the environment where they need them most.

School-Based ABA Support

Therapy during your child’s school day—in their classroom, during lunch, at recess. We help them succeed in the moments that matter: participating in group work, managing frustration when assignments get hard, and navigating social situations with peers.

Telehealth ABA Sessions

Virtual therapy appointments that maintain consistency when in-person isn’t possible. Your family gets flexibility without sacrificing progress.

Parent Training & Coaching

Direct instruction on the same strategies our therapists use. You’ll know how to reinforce appropriate requests during dinner, how to handle escalation at bedtime, how to support your child’s progress between sessions and after therapy ends.

Coverage varies by plan, but we’ll walk you through exactly what yours includes.

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What Makes Partners Health Management Different

Medicaid Tailored Plan for Specific Counties

  • Serves 20 NC counties including Mecklenburg (Charlotte area), Cabarrus, Gaston
  • Manages behavioral health services for Medicaid members
  • Authorization goes through Partners, not NC Medicaid Direct

No Annual Cap for Children Under 21

  • Covers ABA therapy through EPSDT benefit with no dollar limit
  • Services continue as long as medically necessary
  • Part of Medicaid's commitment to comprehensive care for children

Care Coordination Services

  • Assigns Care Manager for families receiving intensive services
  • Care Manager coordinates between ABA provider, school, and medical providers
  • Single point of contact for behavioral health needs

Six-Month Reauthorizations

  • Reauthorization required every 6 months
  • Closely monitors progress through data review
  • May adjust hours or recommend service changes based on progress

No Out-of-Pocket Costs

  • Zero copays or deductibles
  • Authorization timeline: 10-14 business days typically
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How it works
How Kennedy ABA Works in
01

Reach Out

Contact us to learn about ABA therapy. We'll answer your questions, verify your insurance, and explain what to expect. No pressure, just honest conversation.
Reach Out
02

Assessment

A Board Certified Behavior Analyst (BCBA) meets with your family to assess your child's needs, strengths, and challenges. This informs everything we do next.
Assessment
03

Personalized Plan

Your BCBA creates a treatment plan tailored specifically to your child's goals. Every plan is different because every child is different.
Personalized Plan
04

Therapy Begins

Our Registered Behavior Technicians (RBTs) provide one-on-one therapy in the setting that works best for your family—whether that's your home, your child's school, or in the community.
Therapy Begins
05

Progress Tracking

We measure progress with data—not guesses. You'll see exactly what's improving, what needs adjustment, and how far your child has come.
Progress Tracking

How to get started with Partners HealthCare

  • Step: 01
    Contact Kennedy ABA: Call us or fill out our contact form. We'll need your Partners HealthCare member ID and your child's autism diagnosis documentation.
  • Step: 02
    We contact Partners HealthCare: We verify your benefits directly with Partners HealthCare. You'll get clear answers about what's covered.
  • Step: 03
    We submit authorization: We prepare and submit the prior authorization request with all required clinical documentation. Then we follow up with Partners HealthCare until they process it.
  • Step: 04
    Your child starts therapy: Once Partners HealthCare approves coverage, we schedule your child's first session, in your home or at school, based on your family's needs and schedule.
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What ABA Therapy Helps Kids Learn
Communication Skills

Whether your child is nonverbal or struggling with language, ABA helps them express needs, ask questions, and connect with others.

Daily Living Skills

Getting dressed, brushing teeth, following routines—these skills build independence and make life easier for your whole family.

Social Interaction

Making friends, sharing, taking turns, reading social cues—ABA teaches the building blocks of meaningful relationships.

Emotional Regulation

When meltdowns happen, ABA gives your child tools to manage big feelings and respond to frustration in healthier ways.

Behavior Reduction

ABA doesn’t just stop challenging behaviors—it teaches replacement skills so your child can communicate what they need without aggression or self-injury.

School Readiness

Following instructions, sitting for tasks, transitioning between activities—these skills prepare your child for success in schools.

Getting the most from your Partners HealthCare plan

Before starting:

  • Keep your Partners HealthCare card accessible (you'll need both sides)
  • Have your child's autism diagnosis documentation ready
  • Ask us what additional paperwork your specific Partners HealthCare plan requires

During therapy:

  • We monitor your Partners HealthCare authorization periods and benefits utilization
  • We submit reauthorization requests to Partners HealthCare before current approvals expire
  • We update you regularly on coverage status and any Partners HealthCare communications

If Partners HealthCare coverage is limited:

  • We'll appeal denials with strong clinical documentation from our BCBA team
  • We'll explore payment arrangements for out-of-pocket costs
  • Most families find workable solutions—very few end up unable to access services
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About Us

Why families with Partners HealthCare trust Kennedy ABA

We've processed hundreds of Partners HealthCare authorizations. We understand their documentation requirements, typical processing timelines, and how to appeal when they issue questionable denials.
We know how Partners HealthCare works.
You don't need to become fluent in insurance terminology and medical billing codes. We handle everything Partners HealthCare-related from initial verification through final claims.
We manage the entire process.
We verify your Partners HealthCare benefits before therapy begins. You get clear cost information—not vague estimates that turn into surprise billing statements months later.
You know the costs upfront.
In your home during real routines and transitions. At school, during actual lessons and peer interactions. Not in a clinic practicing skills that don't transfer to the environments where your child actually needs them.
Therapy happens where it matters
When Partners HealthCare denies coverage, we explain the actual reason—which often differs from their official denial letter—and appeal with documentation that addresses their real concerns.
We're direct
More About Kennedy ABA
FAQ

Partners HealthCare Coverage FAQs

Depends entirely on your specific plan details. Some Partners HealthCare families pay only their monthly premium with no additional costs. Others have copays ($10-50 per session typically), deductibles, or coinsurance percentages. We verify your exact financial responsibility before your child’s first session.
Some Partners HealthCare plans do, others don’t. We’ll check your specific plan requirements and help you obtain any necessary referrals.
Typically, an official autism diagnosis, a comprehensive treatment plan from our BCBA, and completed prior authorization forms. Sometimes Partners HealthCare requests additional records from your child’s physician or educational team. We handle all submissions and follow-up communications.
Usually 7-14 business days. Sometimes faster when Partners HealthCare has everything they need immediately. Occasionally, longer if they request supplementary documentation or flag the case for additional review. We push for expedited approvals and keep you informed throughout.
Most Partners HealthCare plans in North Carolina approve 10-40 weekly hours, depending on clinical necessity and plan limitations. We request what your BCBA determines your child needs. If Partners HealthCare approves fewer hours, we appeal with clinical justification.
We help you appeal using additional clinical documentation from our BCBA team and your child’s medical providers. Most Partners HealthCare denials get overturned when you provide the right supporting information.
Yes. ABA therapy qualifies as a medical expense, so Partners HealthCare HSA or FSA accounts can cover copays, deductibles, and any out-of-pocket costs.

We work with most major insurance providers in North Carolina. If you have different coverage, we likely work with them. Without insurance, we can discuss self-pay options and payment plans.

Some Partners HealthCare plans extend ABA coverage to ADHD or other developmental conditions. Many don’t. We’ll verify what your specific Partners HealthCare plan covers.
Partners HealthCare typically covers ABA therapy as long as it remains medically necessary. We monitor your benefits throughout treatment and keep you informed about coverage status.
We work with Partners HealthCare throughout North Carolina. During benefits verification, we’ll confirm whether we’re in-network with your specific plan—which typically means lower costs for your family.
Partners HealthCare usually authorizes ABA therapy in 3-6 month periods. We track expiration dates and submit renewal requests 30 days early to prevent service interruptions while Partners HealthCare processes new authorizations.
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Let’s get You Covered

Our team has navigated every variety of Partners HealthCare plan, answered every type of coverage question, and handled every insurance complication imaginable.

This is what we do best, so your child can get the help they need. Fast.

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