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Autism Care Demonstration

Accolade is currently partnered with TRICARE® West Region contractor, Health Net Federal Services to provide Autism Services Navigation to eligible beneficiaries

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Does your child qualify for the ACD?

To qualify for the ACD, your child must be:

Enrolled in a TRICARE® health plan Diagnosed with ASD by an approved TRICARE® provider
Boy with his mother

Are you an active duty service member (ADSM)?

ADSMs with a child diagnosed with ASD must enroll in your service branch’s Exceptional Family Member Program. Your child must also enroll in the Extended Care Health Option (ECHO).

Step 1

Get Diagnosed

Eligible beneficiaries must have an autism spectrum disorder (ASD) (F84.0) diagnosis by a TRICARE-authorized primary care manager (PCM) or specialized ASD-diagnosing provider.

 

Diagnosis occurs under the TRICARE® basic benefit. TRICARE® beneficiaries nominated for the ACD must have their TRICARE-authorized ASD-diagnosing and referring provider submit either a referral or diagnostic evaluation stating a diagnosis of ASD using DSM-5 criteria to initiate the process for enrollment into the ACD.

 

For definitive diagnosis requirements, please visit https://www.tricare.mil/Plans/SpecialPrograms/ACD 
Step 2

Get a Referral and a Authorization

After Health Net Federal Services, LLC (HNFS) has confirmed a beneficiary has met all initial eligibility and definitive diagnosis requirements for the Autism Care Demonstration (ACD), if not already received, the TRICARE-authorized primary care manager (PCM) or specialized ASD-diagnosing provider must submit an ABA referral to HNFS. 

 

ABA referral requests must contain the following:

  • co-morbid diagnosis (if applicable)

  • symptom severity level/level of support  (1-mild, 2-moderate, 3-severe)

  • statement the beneficiary needs ABA services

 

For more information, visit https://www.tricare.mil/Plans/SpecialPrograms/ACD 

 
Step 3

Complete ACD registration process with HNFS

For initial assessment and first treatment steps, visit https://www.tricare.mil/Plans/SpecialPrograms/ACD 
Step 4

Complete outcome measures

All beneficiaries must have complete, valid outcome measure scores in order for HNFS to process treatment authorization requests. TRICARE® requires the submittal of scores and related data points (signature of the respondent and their relationship to the beneficiary) from the following outcome measures:

  • Pervasive Developmental Disorder Behavior Inventory (PDDBI, 1.5 years–18.5 years)

  • Vineland Adaptive Behavior Scales, 3rd Edition (Vineland-3, 0 years–99 years)

  • Social Responsiveness Scale, Second Edition (SRS-2, 2.5 years –99 years), and 

  • Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF, 0 years–12 years) or

  • Stress Index for Parents of Adolescents (SIPA, 11 years–19 years and 11 months) 

 

For more information, visit https://www.tricare.mil/Plans/SpecialPrograms/ACD 
Step 5

Connect with Accolade Autism Service Navigator

The Autism Service Navigator will be assigned after the enrollment criteria has been met. The ASN will serve as a primary health care advocate for the beneficiary and the family. For more information, visit https://www.tricare.mil/Plans/SpecialPrograms/ACD