FFS requests

1. Flow for Accessing ABA Services Across Programs Clinical eval recommends ABA ? No Managed care requests Coordinate the clinical evaluation END Yes Refer to FFS Case Manager Clinical eval recommends ABA ? Yes Refer back to source with FFS determination to pursue next steps under that program Coordinate the ABA evaluation No FFS requests Coordinate the clinical evaluation Authorized ? No Yes END Coordinate ABA services , if authorized, and follow program design Clinical eval by RSN provider ** recommends ABA RSN requests* Yes Not Medicaid eligible or DDD eligible ? Not Medicaid eligible but DDD eligible ? Request received by DDD case resource manager (CRM) No No No DDD requests Medicaid eligible ? END DDD CRM determines coverage; Yes Yes Manage per DDD policy Refer to DDD eligibility • Assumes child currently receiving RSN services • ** A psychologist or psychiatrist