65 | Autism Diagnosis, Waitlists & Insurance Denials | Kimberly Sadovich
Receiving an autism diagnosis can bring answers, relief, uncertainty, and a long list of new questions.
What should you do while waiting for an evaluation? How do you know whether the person completing the evaluation is properly qualified? And what happens when insurance denies a service your child may need?
In this episode of the Autism Family Resource Podcast, Brian Keene speaks with Kimberly Sadovich, Senior Clinical Director at Forta Health, about the early steps families may face while seeking an autism diagnosis and beginning therapy services.
Kimberly shares practical ways parents can prepare while waiting, communicate with providers, respond to insurance barriers, and advocate for support without feeling like they have to manage everything perfectly.
Listen to the Full Episode
This conversation is especially helpful for parents who are currently waiting for an evaluation, have recently received a diagnosis, or are trying to understand what comes next.
Memorable Quote
“Getting a denial is the start of the conversation, not the final end of the conversation.”
In This Episode We Discuss
What parents can do while waiting for an autism evaluation
Why getting on a waitlist early may be helpful
What information to write down before an appointment
How to identify a qualified diagnosing provider
What may happen after receiving an autism diagnosis
How therapy providers can help with insurance denials
Why parents have more influence than they may realize
The importance of caregiver support and self-care
How telehealth services may help some families access care
Preparing While You Wait
One of Kimberly’s main recommendations is to get on an evaluation waitlist as early as possible when concerns arise. In some communities, families may wait many months before an appointment becomes available.
While waiting, parents can begin writing down what they are noticing in everyday life.
This does not need to be a perfect clinical record. Simple notes can be helpful.
You may want to write down:
Situations that seem difficult for your child
When certain behaviors or reactions usually happen
What happened immediately before the situation
How often the concern comes up
Your child’s strengths, interests, and preferred activities
The main questions you want to ask during the evaluation
These notes can make it easier to remember important details when the appointment finally arrives.
Choosing the Right Provider
Kimberly also encourages parents to ask who will be completing the diagnostic evaluation.
Not every professional is qualified to provide a diagnosis that insurance companies will accept. Depending on the insurance plan and the type of service being requested, an evaluation may need to come from a psychologist, psychiatrist, neurologist, developmental pediatrician, or another approved professional.
Before scheduling, parents can ask whether the provider’s evaluation is typically accepted by their insurance company.
Taking a few minutes to confirm this early may help prevent delays later.
What Happens After a Diagnosis?
A diagnosis may help families access services such as occupational therapy, speech therapy, school supports, ABA services, or other community programs.
It can also feel like someone has handed you a large folder without a map.
You may know that support exists but still feel unsure where to start.
Kimberly reminds families that they do not have to build an entire support team overnight. Start with the most important need in front of you. Ask questions, contact providers, and take one step at a time.
Families who are using private-pay services may also have options before receiving a formal diagnosis, depending on the provider and type of support they are seeking.
For additional guidance, read:
Insurance Denials Are Not Always the End
One of the strongest messages from this episode is that an insurance denial does not always mean a service is permanently unavailable.
Sometimes a request is denied because insurance needs additional documentation, more details about a provider, an updated evaluation, or information about the child’s daily schedule.
When this happens, parents should contact the therapy provider involved.
The provider may be able to submit additional records, communicate with the evaluating professional, complete an appeal, or explain what information is missing.
Parents can also call their insurance company, ask whether a care manager is available, and request an update if an appeal has been delayed.
The process can be frustrating, but families do not always have to handle it alone.
Common Questions Parents Ask
What should I do while waiting for an autism evaluation?
Get on the waitlist as early as possible and begin writing down your main concerns, questions, and observations. You can also ask your pediatrician, school, or local early-intervention program about support that may be available while you wait.
What should I do if insurance denies therapy?
Contact the therapy provider and ask why the request was denied. The provider may be able to submit more information, complete an appeal, or guide you through the next step.
Do I have to stay with a provider who does not feel like a good fit?
No. Parents can ask questions, request changes, and explore other providers when the relationship does not feel supportive or appropriate for their family.
Why This Conversation Matters for Families
The period before and after an autism diagnosis can feel heavy.
Parents may be waiting for answers while also managing school, work, appointments, insurance calls, and everyday family life.
Kimberly’s message is not that parents need to do more and more. It is that small, practical actions can help.
Join the waitlist. Keep a few notes. Ask who is completing the evaluation. Follow up after a denial. Let your providers help.
And remember that taking care of yourself is also part of supporting your child.
For more caregiver support, visit:
Resources Mentioned
Autism Learning Partners
School-based IEP supports
Insurance care managers and appeal processes
About Kimberly Sadovich
Kimberly Sadovich is a Board-Certified Behavior Analyst and Senior Clinical Director at Forta Health.
She has experience supporting autistic children, young adults, and families as they navigate evaluations, therapy services, insurance barriers, and virtual care options.
Related Resources for Parents
If you found this episode helpful, you may also enjoy:
Just Diagnosed? A Guide for Arizona Parents Starting the Autism Journey
IEP 101: How to Advocate for Your Child in the School System
Caring for the Caregiver: Self-Care Tips for Parents of Kids with Special Needs
Home-Based Therapy: 5 Benefits of In-Home Pediatric Care for Children with Disabilities
Explore more parent resources at:
