Clinical Necessity Reviews

Your ABA provider must submit a treatment plan to request ABA services. TriWest’s clinical team will complete a clinical necessity review of the goals, requested hours of ABA services, location of services, and results of outcome measures. If we need more information, we will notify your ABA provider in writing. Your ABA provider must submit the missing information before completion of the review. We will inform you and your ABA provider in writing when we approve ABA services.