Reminder: Behavioral Analysis (BA) Provider Changes Require New Authorization

Date: 07/15/26

Sunshine Health reminds providers that when a member transfers from one provider/practice/organization to another, they must adhere to the requirements outlined below. This will help ensure a smooth transition for your patients, our members.

The new provider must:

• Follow the standard initial authorization request process and request an initial 24 units before requesting treatment codes.
  Complete and submit the following:
  • Their own assessment and treatment plan
  • A new assessment of the child’s current functioning, as required
  • New, fully updated core instruments (Vineland and BASC)
  • A completed Behavior Analysis (BA): Change of Provider Form (PDF)
  • A completed and signed PCP Acknowledgement and Care Coordination Form (PDF)
• Submit an authorization request. Authorizations cannot be transferred from one provider to another.
   Provide their own clinical documentation. Sunshine Health cannot utilize clinical documentation completed by a previous provider to support a new authorization request.
• Complete and submit their own clinical documentation using new, current data, as required.

For more information regarding required documentation, please visit: Required Documents for Behavioral Analysis (BA) Providers.

Download These Forms

• Behavior Analysis (BA): Change of Provider Form (PDF) 
• Behavior Analysis Prior Authorization Request Form (PDF)
• PCP Acknowledgement and Care Coordination Form (PDF)

Questions?

Sunshine Health has a wealth of resources available to help answer your questions and address your concerns:

• Provider Support Guide: Find the Right Contact
• Provider Services: Call 1-844-477-8313
• Secure Provider Portal: Visit the Secure Provider Portal to check member eligibility, submit claims and more.
• Provider Engagement: Use the Find Your Account Manager tool to find the Provider Engagement Account Manager (PEAM) supporting your specialty and region.
• Claim Concerns: Resolve outstanding claims using the Claim Concerns form.
• Provider News: Bookmark Provider News to keep up with the latest updates.
• Provider Newsflash: Subscribe to our e-newsletter to get regular updates.
• Provider Resources: Visit Manuals, Forms and Resources to find provider manuals, important forms, scheduling standards and other resources.

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