AuraComply
Prior Authorization Compliance for ABA Therapy
▶ Run Example Case — See It Working in 60 Seconds
No real patient data needed — pre-fills a demo case so you can see the compliance check instantly
Patient Information
First Name
*
Last Name
*
Date of Birth
*
Member ID
*
State
*
Select state…
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Insurance Payer
*
Select payer…
Aetna ABA Commercial
Anthem ABA Commercial
UnitedHealthcare ABA Commercial
BCBS ABA Commercial
Cigna ABA Commercial
Humana ABA Commercial
Molina Medicaid
Standard Medicaid Base
Authorization Request
Auth Request Type
Initial Authorization
Renewal
Extension
Auth Period (weeks)
Auth Start Date
Prior Auth Number (if renewal/extension)
Diagnosis & Assessment
ICD-10 Code
*
Select diagnosis…
F84.0 — Autistic Disorder
F84.5 — Asperger Syndrome
F84.8 — Other Pervasive Developmental Disorders
F84.9 — Pervasive Developmental Disorder, Unspecified
F90.0 — ADHD Predominantly Inattentive
F90.1 — ADHD Predominantly Hyperactive
F90.2 — ADHD Combined Type
F71 — Moderate Intellectual Disability
F72 — Severe Intellectual Disability
F73 — Profound Intellectual Disability
Diagnosis Date
Diagnostic Tool
Select…
ADOS-2
ADI-R
CARS-2
DSM-5 Criteria
Assessment Type
VB-MAPP
ABLLS-R
AFLS
Vineland-3
ADOS-2
BASC-3
Assessment Score / Level
Assessment Date
Clinical Summary
*
Safety Concerns
Telehealth?
No — In-person only
Yes — Telehealth sessions
Hybrid
Setting
Clinic
Home
School
Community
FBA Status
Select…
Completed
In Progress
Not Required
Recommended
Prior ABA Services
Select…
None — First time
Yes — Same agency
Yes — Different agency
Lapsed (>6 months)
CPT Codes & Units
Include
CPT
Description
Units/Wk
Hrs/Wk
97153
Individual DTT (1:1 Tech)
8.0
97154
Group DTT (Tech)
0.0
97155
BCBA Protocol Modification
2.0
97156
Caregiver Training (1:1)
1.0
97157
Multi-Family Group Training
0.0
97158
Group Adaptive Behavior
0.0
CMS MUE Cap (8 hr/day): Direct services total = 8.0 hrs/wk ✓ Compliant
Provider Information
BCBA Full Name
*
BCBA License #
BCBA NPI
BCBA Certification #
Agency / Clinic Name
Clinic NPI
Supervising Physician
Physician NPI
Supervision Hrs/Month
*
Credential Level
*
BCBA
BCBA-D
QBA
RBT
BCaBA
Caregiver Involvement
Caregiver Training Goals
Language Barrier
No
Yes
Single Caregiver Household
No
Yes
Work Schedule Conflict
No
Yes
Housing Instability
No
Yes
✦ Generate Prior Authorization Draft
⚠️ DRAFT — MANDATORY BCBA CLINICAL REVIEW REQUIRED BEFORE SUBMISSION
Risk Intelligence Dashboard
Risk Score
—
Decision
—
Rules Passed
—
Rules Failed
—
Revenue Protected
—
Action Required — Remediation Plan
Prior Authorization Draft
Generating draft…
Copy Draft to Clipboard