ABA Referral Checklist for Case Managers and Care Coordinators
What a complete ABA referral includes, where referrals commonly stall, and how to hand a family off so services can start as smoothly as possible.
This guide is educational and does not replace medical, legal, school, or insurance advice. Referral and authorization requirements vary by health plan and by family. Always confirm requirements with the child's specific Medicaid managed care plan or insurance carrier and with the ABA provider receiving the referral.
Read this first: a referral starts a process; it does not authorize services. When you refer a family to an ABA provider, the provider reviews the information, works with the family through intake, and the child's health plan makes the coverage and authorization decisions. No referral, however complete, guarantees approval, hours, or a start date. What a complete referral does is remove the avoidable delays, and that is worth a great deal to the family.
If you coordinate care for children in Florida, you have probably seen both versions of an ABA referral. In one, the packet arrives complete, the family is expecting the provider's call, and intake moves straight into scheduling conversations. In the other, the provider receives a name and a phone number, the family does not recognize the number when it rings, and three weeks pass before anyone realizes the diagnostic evaluation was never attached.
Neither version reflects on anyone's effort. Referring professionals juggle heavy caseloads, and ABA packet expectations are genuinely easy to miss because they vary by plan. This guide is the professional-side companion to the process: the referral pathway from first conversation to submission, what a complete packet contains, where referrals most often stall, and a checklist you can copy into your own workflow. Families preparing their own submission have a dedicated counterpart in our family checklist, Before You Submit ABA Intake.
Why Referral Completeness Matters
Under Florida Medicaid, behavior analysis services for most children under 21 run through the child's Statewide Medicaid Managed Care plan (members not enrolled in managed care follow a separate state review pathway), and the reviewing plan assesses medical necessity before services begin. That review is built on documents. When the referral arrives with the core items present and current, the provider's intake team can verify eligibility and move toward an assessment conversation quickly. When items are missing, the intake team has to track them down, usually through the family, who may not know what the terms mean or where the documents live.
A complete referral does not speed up the plan's decision. It removes the waiting that happens before the plan ever sees the case.
The Referral Pathway, Step by Step
The exact sequence varies by organization, but a well-run ABA referral generally moves through six steps.
1. Confirm the family actually wants this referral. It sounds obvious, and it is one of the most commonly skipped steps. A referral the family did not expect (or did not understand) tends to go unanswered.
2. Confirm basic fit before you send. A brief call to the provider saves everyone time: Does the provider serve the family's county? Does it deliver services in the setting the family needs (home, school, daycare, community)? Is it currently accepting referrals for the child's specific plan? A quick fit check can prevent unnecessary back-and-forth later.
3. Assemble the packet. The next section lists the contents. Items you cannot obtain are worth flagging rather than omitting silently: "CDE requested from Dr. Alvarez's office, expected next week" is useful information; a silent gap is a mystery.
4. Confirm consent to share. A signed release of information covering the referral lets the provider talk to you about the case rather than only to the family; without one, the provider may be limited in what it can confirm back to you. The mechanics of releases, what they cover, and secure ways to send them are explained in our guide to consent, records, and secure communication.
5. Send it through an approved channel and confirm receipt. A referral that was faxed into the void helps no one. Ask the intake team to confirm what arrived and whether anything is missing.
6. Warm-hand-off the family. Tell the family who will contact them, from what organization, and what the call will cover. More on this below: it can make the handoff much smoother.
What a Complete Referral Packet Includes
Requirements vary by plan, so treat this as the common core and confirm specifics with the receiving provider. Each document is listed here by name only; plain-language definitions of what each one is, who issues it, and why plans ask for it live in our document guide for Florida families.
That last item is worth underlining. A surprising number of referrals arrive with excellent information about the child and no way to reach the professional who sent them.
Where Referrals Commonly Stall
These are the gaps intake teams see most often from the professional side. All are preventable, and none require blame; they are simply where the process leaks time.
The family was not expecting the call. The provider dials an unfamiliar number, the family lets it ring, and the referral ages quietly in a queue. This is the most common stall and the easiest to prevent.
The plan information is stale. The referral names the plan the child had at the last care-plan review, not the plan the child has now. The provider discovers the change during verification and the packet needs updating.
No release of information is on file. The provider cannot loop you in on status, so the referral loses its coordinator: the family becomes the only channel, which is exactly what your involvement was meant to relieve.
The packet points to documents instead of containing them. "CDE on file at the pediatrician's office" is a lead, not a document. If you cannot obtain it, flag it; if you can, attach it.
The referral went to a provider that cannot serve the family. Wrong county, wrong setting, or a plan the provider cannot accept referrals for. The two-minute fit call in step 2 exists for this reason.
The consent-holder is unclear. A grandparent raising the child, a foster placement, a custody arrangement. When the referral is silent about who can consent, the provider has to untangle it before intake can properly begin.
The Warm Hand-Off
A warm hand-off is the difference between a referral and an introduction. It takes about five minutes, and it usually looks like this.
Tell the family the specifics. The provider's name, that a call or message is coming, roughly when outreach typically happens (the provider can tell you what to say), and what the first conversation covers: verifying information and explaining next steps, not committing the family to anything.
Preview the questions. Let the family know the intake team may ask about documents, insurance, and where services would happen, and reassure them that "I don't have that yet" is an acceptable answer.
Name yourself as a resource. If the family knows they can call you when something in the process is confusing, small problems surface early instead of becoming silent stalls.
Consider an everyday example. A care coordinator refers a four-year-old for ABA and moves on to the next case. The provider calls twice from a number the family does not recognize; the family, wary of spam calls, never picks up. A month later, at the next check-in, the coordinator learns nothing has happened. In the alternate version, the coordinator spends five minutes telling the family the provider's name and that a call is coming this week or next, and the family answers on the first ring. Same referral, same packet, same provider. The five minutes was the difference.
If the Child Is Coming From Another ABA Provider
Transitions add a layer: the health plan may need to review, close, update, or replace information connected to the prior provider before the new provider can begin, and any transition or discharge documentation may be requested when appropriate rather than being universally required; requirements vary by plan and individual circumstances. Flag the transition clearly in your referral so the receiving provider can ask the right questions early, and see our full guide to provider transitions, including the case manager's role in it.
Questions to Ask a Provider Before You Refer
A short call with the intake team, before the packet goes anywhere, sets the whole referral up well. Fair questions include:
These answers help set expectations for how communication will work after the referral, too.
What You May Expect After Submitting
Every provider's process differs, so hold this loosely, but in general, after a complete referral you may expect an acknowledgment that the packet arrived, outreach to the family, a request to you or the family for anything missing, and, where a release permits, periodic status updates at the milestones you have asked about. What no provider should offer is a promised authorization, a promised number of hours, or a promised start date; those depend on the plan's review and the individual case. The stage-by-stage sequence a family moves through after submission is covered in What Happens After You Submit an ABA Intake?; the short version for your calendar is: set a follow-up date when you submit, and ask the intake team which milestone is worth checking on next.
The ABA Referral Checklist
Copy this into your own workflow and adapt it to your organization. Document definitions live in the document guide; confirm plan-specific requirements with the receiving provider.
Before you refer
☐ Family has agreed to the referral and knows the provider's name
☐ Provider confirmed for county, setting, and the child's specific plan (by plan name)
☐ Consent-holder identified: who has legal authority to consent for this child
☐ Plan enrollment confirmed as current, not assumed from an older record
The packet
☐ Comprehensive Diagnostic Evaluation (CDE): most recent complete, signed copy
☐ Physician's order or referral for behavior analysis services, where the plan requires one
☐ Plan name and member ID as currently enrolled
☐ Parent or legal guardian contact information, including preferred language
☐ Guardianship or custody note, if the consenting adult is not a parent with legal authority
☐ Intended service setting, county, and address; school or daycare name if applicable
☐ Signed release of information covering this referral
☐ Brief service-history note (prior ABA or current related therapies), if applicable
☐ Your name, role, organization, direct phone, email, and best contact times
☐ Any missing item flagged with its status, not silently omitted
The hand-off
☐ Family told who will call, from what organization, and what the first call covers
☐ Family told that "I don't have that yet" is a fine answer to intake questions
☐ Family knows they can contact you if anything in the process is confusing
After you submit
☐ Receipt confirmed with the intake team, including whether anything is missing
☐ Follow-up date on your calendar
☐ Next milestone identified: what you will ask about when you follow up
☐ Any plan change, address change, or new document forwarded promptly
How Blooming Works With Referring Professionals
Blooming Behavioral Health provides ABA services in Broward, Miami-Dade, and Palm Beach counties, delivered in natural settings (home, school, daycare, and the community) rather than in a center.
When a case manager or care coordinator refers a family, our intake team can:
We do not determine Medicaid eligibility or coverage, and we do not guarantee authorization, approved hours, staffing, school access, or a start date. Those decisions rest with the child's plan and the individual circumstances.
If you would like to confirm fit before sending a referral, call us at (754) 799-3780 or visit our page for professionals. Families who prefer to start directly can begin an intake.
A complete packet and a five-minute hand-off will not change what the plan decides. They can reduce avoidable delays before the plan's decision, and that is the part of the process you control.
Reviewed for operational and compliance accuracy by Carlos Marquez, Director of Services and Compliance Officer.
Florida Medicaid Policy
- AHCA — Florida Medicaid Behavior Analysis Services Information page. https://ahca.myflorida.com/medicaid/medicaid-policy-quality-and-operations/medicaid-policy-and-quality/medicaid-policy/medical-and-behavioral-health-coverage-policy/behavioral-health-and-health-facilities/behavior-analysis-services-information.html
- Florida Medicaid Behavior Analysis Services Coverage Policy, December 2024 (PDF). https://ahca.myflorida.com/content/download/25728/file/Florida%20Medicaid%20Behavior%20Analysis%20Services%20Coverage%20Policy.pdf
- AHCA — Statewide Medicaid Managed Care. https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care.html
Federal Privacy Guidance
- HHS — Summary of the HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
Clinical Standards
- CASP — ABA Treatment of Autism Spectrum Disorder: Practice Guidelines (Version 3.0, April 2024). https://www.casproviders.org/asd-guidelines/
Plan Enrollment Verification
- Florida KidCare. https://floridakidcare.org/ — 1-888-540-KIDS (1-888-540-5437)
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