Requesting Insurance Reimbursement

To request Ascent Autism's assistance in obtaining out-of-network reimbursements from your insurance, please complete the following form. Ascent works in collaboration with a third-party service to handle insurance follow-ups on your behalf. Kindly note that submitting the form does not guarantee reimbursement success through the third party.

Upon completion of a benefits check and confirmation of your out-of-network coverage, we will initiate the billing process with your insurance provider automatically. Reimbursements from your insurance may either be mailed directly to your home or sent to Ascent Autism. If the latter is the case, one of our representatives will promptly contact you to arrange reimbursement.