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Healthy Blue Louisiana forms are official Medicaid Managed Care documents used by healthcare providers, behavioral health specialists, and care coordinators to request services, authorizations, and coverage determinations for Medicaid recipients across Louisiana. This category currently features the Medicaid Managed Care Applied Behavior Analysis Authorization Request form (BLAPEC-1989-20), which is central to obtaining prior authorization for ABA therapy services — a critical step before treatment can begin for eligible members.
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About Healthy Blue Louisiana forms
These forms are primarily completed by licensed psychologists, board-certified behavior analysts (BCBAs), and other qualified healthcare professionals who need to document medical necessity, treatment plans, and specific service codes when requesting coverage for Applied Behavior Analysis services. Parents and caregivers of children with autism spectrum disorder or related developmental conditions may also encounter these forms as part of the authorization process. Accurate and complete submission is essential, as errors or omissions can delay approvals and interrupt care.
Because these forms require precise clinical and administrative details — including CPT codes, recipient demographics, and provider attestations — completing them correctly can be time-consuming. Tools like Instafill.ai use AI to fill these forms in under 30 seconds, helping providers submit accurate, compliant requests without the usual paperwork burden.
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How to Choose the Right Form
With only one form in this category, choosing is straightforward — but knowing when and how to use it correctly is what matters most.
Who Should Use This Form
The Medicaid Managed Care Applied Behavior Analysis — Authorization Request (BLAPEC-1989-20) is specifically designed for:
- Licensed psychologists requesting prior authorization for ABA assessments or therapy
- Board-certified behavior analysts (BCBAs) submitting treatment plans for Medicaid recipients
- Other qualified health care professionals authorized to prescribe or oversee ABA services in Louisiana
If you are a caregiver or parent, this form must be completed and submitted by the treating provider, not the recipient or their family.
When You Need This Form
Use the BLAPEC-1989-20 when you need prior authorization for:
- Functional behavior assessments (CPT codes 97151–97152)
- ABA-based therapy and protocol modifications (CPT codes 97153–97158)
- Initial authorization requests or reauthorization for ongoing ABA services
Key Things to Confirm Before Filling It Out
- The recipient is an active Healthy Blue Louisiana Medicaid member
- The requested ABA services are not already covered under an IFSP or IEP
- You have the recipient's diagnosis details, living arrangement information, and a completed treatment plan ready
- Correct CPT codes, requested hours, and units are documented
Filling It Out Quickly
The PDF version of this form can be complex and time-consuming. Tools like Instafill.ai allow providers to fill it out faster using AI assistance — and can convert non-fillable PDF versions into interactive forms, reducing errors and submission delays.
Form Comparison
| Form | Purpose | Who Files It | When to Use |
|---|---|---|---|
| Medicaid Managed Care Applied Behavior Analysis — Authorization Request (Healthy Blue Louisiana, BLAPEC-1989-20) | Request prior authorization for ABA therapy services | Licensed psychologists, BCBAs, qualified health professionals | Before providing ABA services to Louisiana Medicaid recipients |
Tips for Healthy Blue Louisiana forms
Healthy Blue Louisiana requires that ABA authorization requests be submitted by licensed psychologists, BCBAs, or other qualified professionals. Double-check that the supervising provider's credentials, NPI number, and license information are current and accurately entered before submission to avoid automatic denials.
The form requires specific CPT codes (97151–97158) tied to the exact ABA services being requested. Make sure each code corresponds correctly to the service type, requested hours, and units — mismatches are a common reason for authorization delays or rejections.
Healthy Blue Louisiana will not authorize ABA services that duplicate what is already covered under an Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP). Review the recipient's existing service plans carefully and document clearly that the requested ABA services are non-duplicative.
The form requires detailed recipient demographics, Medicaid ID, diagnosis codes, and living arrangement details. Collect all of this information before you begin filling out the form to avoid incomplete submissions, which can reset your review timeline.
AI-powered tools like Instafill.ai can fill out the Healthy Blue Louisiana ABA Authorization Request form quickly and accurately, reducing manual data entry errors. Your data stays secure throughout the process, making it a practical time-saver for providers managing multiple authorization requests.
Prior authorization for ABA services hinges on demonstrating medical necessity. Include supporting clinical documentation, functional assessment results, and a clear treatment plan attestation to strengthen your request and reduce the likelihood of a denial or request for additional information.
Always save a completed copy of the form and any supporting documents after submission. If an authorization is disputed or a resubmission is needed, having a record of exactly what was submitted will save significant time and help resolve discrepancies faster.
Some versions of the BLAPEC-1989-20 form are non-fillable PDFs, which can make accurate completion difficult. Services like Instafill.ai can convert these into interactive fillable forms, allowing you to type directly into fields and reduce handwriting or formatting errors.
Frequently Asked Questions
The Healthy Blue Louisiana ABA Authorization Request form (BLAPEC-1989-20) is an official Medicaid Managed Care document used to request prior authorization for Applied Behavior Analysis (ABA) services. It is designed for licensed psychologists, BCBAs, and other qualified health care professionals seeking coverage approval for ABA therapy and functional assessments for eligible Medicaid recipients in Louisiana.
This form must be completed by licensed health care professionals such as board-certified behavior analysts (BCBAs), licensed psychologists, or other qualified providers who are requesting ABA services on behalf of a Medicaid-eligible recipient in Louisiana. It is not intended to be filled out by patients or their families directly.
The form covers ABA-based services billed under CPT codes 97151 through 97158, including functional behavior assessments and ABA-based therapy sessions. Providers must specify the requested hours and units for each service type when submitting the authorization request.
Healthy Blue Louisiana requires prior authorization to verify that ABA services are medically necessary, not duplicative of services already covered under an Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP), and compliant with Medicaid Managed Care coverage guidelines. This process helps ensure appropriate and coordinated care for recipients.
Providers should have the recipient's demographic details, Medicaid ID, diagnosis information, and relevant CPT codes on hand, along with their own provider credentials and contact information. Details about the recipient's living arrangements, treatment plan, and the specific ABA services being requested are also required.
Completed forms should be submitted to Healthy Blue Louisiana through the plan's designated prior authorization submission process, which may include fax, an online provider portal, or mail. Providers should consult Healthy Blue Louisiana's provider resources or contact their provider relations team to confirm the preferred submission method.
Processing times for prior authorization requests can vary depending on the completeness of the submitted form and the urgency of the request. Providers should contact Healthy Blue Louisiana directly for information on standard and expedited review timelines.
Yes, AI-powered tools like Instafill.ai can fill out the Healthy Blue Louisiana ABA Authorization Request form in under 30 seconds by accurately extracting and placing data from source documents. Instafill.ai can also convert non-fillable PDF versions of the form into interactive, fillable formats, making the process faster and reducing the risk of errors.
Manually completing the form can take anywhere from 15 to 30 minutes depending on the complexity of the case and how readily available the required information is. Using an AI tool like Instafill.ai, the form can be populated accurately in under 30 seconds by pulling data directly from existing clinical or administrative documents.
Submitting an incomplete or inaccurate form can result in delays, denials, or requests for additional information from Healthy Blue Louisiana. Providers should carefully review all fields — including diagnosis codes, CPT codes, and treatment plan attestations — before submission to avoid disruptions in care for the recipient.
Yes, the BLAPEC-1989-20 form is specific to Healthy Blue Louisiana's Medicaid Managed Care program and is intended for use by providers serving Medicaid-eligible recipients in the state of Louisiana. Providers in other states or with other insurance plans would need to use the appropriate authorization forms for those programs.
Glossary
- Applied Behavior Analysis (ABA)
- A therapy based on the science of learning and behavior, commonly used to improve social, communication, and learning skills in individuals with autism spectrum disorder (ASD). ABA services require prior authorization from Healthy Blue Louisiana before treatment can begin.
- Prior Authorization
- Approval that a provider must obtain from Healthy Blue Louisiana before delivering certain services, such as ABA therapy, to confirm the treatment is medically necessary and covered under the member's Medicaid plan.
- Medicaid Managed Care
- A system where Louisiana's Medicaid program contracts with private health plans like Healthy Blue to coordinate and deliver healthcare services to eligible low-income residents, rather than the state paying providers directly.
- Board-Certified Behavior Analyst (BCBA)
- A credentialed professional licensed to design, supervise, and implement Applied Behavior Analysis programs. BCBAs are among the qualified providers authorized to submit ABA authorization requests to Healthy Blue Louisiana.
- CPT Codes (97151–97158)
- Current Procedural Terminology codes used to identify specific ABA services for billing and authorization purposes, such as behavior assessments (97151) and treatment interventions (97153–97158). These codes must be listed on the authorization request with the number of hours and units needed.
- Functional Behavior Assessment (FBA)
- A structured evaluation process used to identify the causes and patterns of a patient's challenging behaviors, forming the foundation for an individualized ABA treatment plan. An FBA is often required as part of the ABA authorization request.
- Individualized Education Program (IEP)
- A federally mandated plan developed for school-age children with disabilities that outlines special education and related services. Healthy Blue Louisiana requires that ABA services do not duplicate services already provided under an IEP.
- Individualized Family Service Plan (IFSP)
- A plan developed for infants and toddlers (under age 3) with developmental delays that outlines early intervention services. ABA services authorized by Healthy Blue must not overlap with services already covered under an IFSP.
- Medical Necessity
- A standard used by Healthy Blue Louisiana to determine whether a requested service, such as ABA therapy, is appropriate and required based on the member's diagnosis, condition, and clinical evidence. Services that do not meet medical necessity criteria will not be authorized.
- Healthy Blue Louisiana (BLAPEC)
- A Medicaid managed care organization operating in Louisiana, identified by the plan code 'BLAPEC' on official forms. It administers Medicaid benefits, including behavioral health services like ABA therapy, for eligible Louisiana residents.