Assessment Intake Process
How to request approval for an Assessment
Send via email
STEP
1
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1. Send an email to pbtinc@gmail.com with the referral filled and attached.
2. Then confirm that our administrative assistant received it.
3. Send a copy of your Insurance card back and front to check your eligibility to our programs.
4. If you are a Medicaid Client, submit a Doctors referral, EQ Clinical questions and CDE (If you do not have a CDE and you have an IEP, check that it has psychological tools administered.)
5. Our administrative assistant will submit all the information and will contact you when our Initial Assessment is approved.
6. Wait for a reply from our email.
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*we will start processing the authorization of your assessment and we will ask you additional forms from you authorizing us to be your provider.
If you are working with another company and you decide to change, please fill a change of provider form as well
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1. After our administrative assistant contacts you that your assessment is approved, give them 3 options preferably in the mornings to schedule an appointment with our BCBA to start the assessment process. Our administrative assistant will send you some forms to fill and have ready to be sent back to him before the first appointment.
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*After we get authorization to start your services we will ask you to fill additional forms that we will email to you, please email them back to us as soon as possible.
We have 30 days to complete your assessment. The assessment will include at least 2 appointments with you and we will ask you to gather data, videos and fill other forms as needed.
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STEP
2
Once the appropriate instructions are filled, and your assessment(s) have been approved, please fill all PBT questionnaires as requested by our office.
*Please ensure to request these forms and documents when needed.
*Send ABC, FAST and Tally sheet completed.
PBT Forms
Bill of rights
Grievance procedure
HIPPA
Consent to Behavioral Intervention
Expectations
Abuse and Neglect
Release of information
Photograph and video release form
Telemedicine approval
Covid procedures / waiver
Before the first interview send the Functional assessment Interview (FAI) form filled.
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FAI
After the first interview fill the ABC form and the FAST for each problem behavior of concern.
FAST
ABC
Videos
Tally
Sheets
Appointment [Week 1]
1. The first appointment will be with the parents if the appointment was for a child.
Your BCBA will go over all the forms and information with you during the appointment and schedule together the second appointment with the child.
During this first appointment, your BCBA will train you how to collect data and how to record some videos regarding the child/parent interactions or behavior problems.
*please send back all data and videos within the week
Appointment [Week 2]
1. During the second appointment, we will go over all the information gathered and pending.
2. An assessment report and behavior treatment plan will be completed and submitted to your funding source for approval and request of services hours.
3. When the hours are approved we will contact you to start providing services.
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After services are approved
1. We will train you and whoever will be involved and we will complete a competency check to ensure everybody has the knowledge and skills to implement our treatment plan.
When everybody is trained and gets 80% on a fidelity check, the plan will be implemented.
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*Progress will be tracked, daily, weekly and monthly.
*Fidelity checks will be completed at least every 6 months.
*Parent participation will be tracked daily.
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Think about whether you want / could remote, remote and in-person services or just in person to plan properly.