Terms of Service
Effective date: May 1, 2026 · Last updated: May 6, 2026
1- Parties to this Agreement
This Terms of Service agreement (“Agreement”) is entered into between Blue Horizon Professional Group, Inc. (“Blue Horizon,” “we,” or “the Provider”), a Florida-registered healthcare corporation providing center-based Applied Behavior Analysis (ABA) therapy services, and the legal representative of the minor patient enrolling in our services (“you,” “the Family,” or “Legal Representative”).
Our service locations
- Fort Myers Center — serving Lee County and surrounding communities
- Lehigh Acres Center — serving eastern Lee County and surrounding communities
Both centers operate under the same policies, standards, and terms described in this Agreement.
Who is the “Legal Representative”?
For the purposes of this Agreement, the Legal Representative is the parent(s) or legally designated guardian(s) of the minor patient, as recognized by Florida law. Only an authorized Legal Representative may consent to treatment, access clinical records, make financial decisions, and enter into binding agreements on behalf of the minor. In cases of shared or disputed custody, the provision of these Terms of Service is governed by applicable Florida family law.
2- Eligibility & Admission
Clinical eligibility ABA
Services at Blue Horizon are designed for children and adolescents with a documented diagnosis of Autism Spectrum Disorder (ASD) or other conditions for which ABA therapy is clinically appropriate and medically necessary. An existing diagnosis from a licensed healthcare professional (e.g., developmental pediatrician, psychologist, or psychiatrist) is required prior to the initiation of services.
Initial evaluation
Upon referral or inquiry, a Board Certified Behavior Analyst (BCBA) will conduct an initial clinical assessment to determine appropriate treatment intensity, goals, and program fit. This evaluation is a required step before services begin and does not guarantee enrollment.
Informed consent FL
Before any services begin, the Legal Representative must sign a written Informed Consent form confirming understanding of the nature, goals, risks, and alternatives of ABA therapy. Consent may be withdrawn at any time; see Section 6 for details on patient rights.
Insurance verification INS
Blue Horizon requires verification of insurance benefits (Verification of Benefits, or VOB) prior to the commencement of services. Enrollment is contingent on confirmed insurance coverage or an agreed alternative payment arrangement. The Legal Representative is responsible for ensuring accurate and current insurance information is on file at all times.
3- Nature of ABA Services
Blue Horizon provides center-based Applied Behavior Analysis (ABA) therapy at our Fort Myers and Lehigh Acres locations. Services are not provided in the home under this agreement unless separately contracted and authorized.
Clinical team ABA
- BCBA (Board Certified Behavior Analyst): Responsible for developing, supervising, and updating the individualized treatment plan. The BCBA conducts regular assessments (using tools such as VB-MAPP, ABLLS-R, or similar) and holds clinical responsibility for the program.
- BT / RBT (Behavior Technician / Registered Behavior Technician): Works directly with the child under the supervision of the BCBA, implementing the behavior intervention plan during sessions.
Treatment plan
Each child receives an individualized behavior intervention plan (BIP) based on clinical assessment. Goals are reviewed and updated at regular intervals (typically every 6 months, or as clinically indicated) and shared with the Legal Representative. Adjustments to session frequency, intensity, and goals are made based on clinical progress and insurance authorization.
Parent/caregiver training FL
Caregiver participation and training are a clinically essential component of ABA therapy, not optional. The Legal Representative agrees to participate in scheduled parent training sessions as recommended by the BCBA. Active family involvement significantly impacts the generalization of skills across environments.
School and external coordination
With the written authorization of the Legal Representative, Blue Horizon may collaborate with the child’s school team, IEP committee, or other service providers to ensure a coordinated approach to treatment. This sharing of information is governed by HIPAA and Florida law (see Section 7).
4- Responsibilities of the Legal Representative
Attendance and punctuality
Regular and consistent attendance is essential for clinical progress. The Legal Representative agrees to bring the child to scheduled sessions on time. Consistent tardiness or early departures that reduce session time may negatively impact the treatment plan.
Cancellation policy
We require at least 24 hours’ advance notice for session cancellations or rescheduling. Cancellations without sufficient notice, or repeated no-shows, may result in adjustments to the child’s schedule, reduced session slots, or — in cases of persistent non-attendance — review of continued enrollment. Frequent absences may also impact insurance authorizations.
Maintaining accurate insurance information INS
The Legal Representative is responsible for promptly notifying Blue Horizon of any changes to insurance coverage, plan, or policy number. Failure to provide updated insurance information in a timely manner may result in claim denials for which the Legal Representative may be held financially responsible.
Health and safety notifications HIPAA
The Legal Representative agrees to inform Blue Horizon of any significant changes in the child’s health, medications, diagnoses, or behaviors that may affect the safety or appropriateness of the treatment plan. This obligation exists independently of HIPAA protections and is required for clinical safety.
Center conduct and safety
The Legal Representative agrees to comply with all safety and conduct policies established at our Fort Myers and Lehigh Acres centers. Blue Horizon reserves the right to establish and enforce reasonable behavioral expectations for both children and accompanying adults to ensure a safe environment for all clients and staff.
5- Billing & Insurance Coverage
Insurance billing process INS
Blue Horizon will submit claims to the Legal Representative’s insurance carrier for services rendered, using applicable ABA CPT codes (including 97151, 97152, 97153, 97154, 97155, 97156, 97157, and 97158, as applicable). Claims are subject to the terms, conditions, and limitations of the client’s specific insurance plan.
Prior authorization INS
Most insurance plans require prior authorization (PA) before ABA therapy services can be reimbursed. Blue Horizon will assist in obtaining the initial authorization and managing renewals; however, the Legal Representative understands that authorization approval is the decision of the insurance carrier and is not guaranteed. Services provided without active authorization may not be covered.
Client financial responsibility
The Legal Representative is responsible for all amounts not covered by insurance, including but not limited to: deductibles, copayments, coinsurance, and any services specifically excluded from the plan. Blue Horizon will provide an estimate of expected out-of-pocket costs based on the VOB prior to the start of services; however, these estimates are not guarantees of final billing amounts.
Florida ABA insurance mandate FL
Florida law requires that health insurance policies issued in the state of Florida cover medically necessary ABA services for individuals diagnosed with Autism Spectrum Disorder. If your insurer denies coverage for ABA therapy, you have the right to appeal and/or file a complaint with the Florida Department of Insurance.
Accepted insurance plans
Blue Horizon works with a range of insurance providers including Medicaid and commercial plans. For an up-to-date list of accepted plans, please contact our billing department or visit our website. We can also assist families in navigating Florida KidCare and Medicaid EPSDT benefits that cover ABA services.
Payment, billing disputes, and collections
Invoices for amounts owed by the Legal Representative are due within 30 days of issuance. Blue Horizon will make reasonable good-faith efforts to resolve billing discrepancies. Accounts with outstanding balances beyond 90 days may be referred to a third-party collection agency, and continued services may be placed on hold pending resolution.
Denied claims and appeals
If an insurance claim is denied, Blue Horizon will notify the Legal Representative promptly. We will assist in the appeal process; however, the final determination rests with the insurance carrier. The Legal Representative has independent rights to appeal claim denials directly with their insurer and may seek assistance from the Florida Department of Financial Services.
6- Informed Consent & Patient Rights
Florida Patient’s Bill of Rights FL
As a healthcare provider in Florida, Blue Horizon recognizes and upholds the rights of all patients as defined under the Florida Patient’s Bill of Rights and Responsibilities (Florida Statute §381.026). These rights include, but are not limited to:
- The right to receive care without discrimination on the basis of race, ethnicity, national origin, disability, or other protected characteristics
- The right to receive treatment information in a language and manner that can be understood
- The right to participate in the development of the treatment plan
- The right to know the qualifications of the clinical staff providing care
- The right to receive an itemized explanation of charges
- The right to file a complaint without fear of retaliation
Right to withdraw consent
The Legal Representative may withdraw consent for treatment at any time. Withdrawal of consent must be communicated in writing to Blue Horizon and will result in the scheduling of a clinical transition plan to ensure the child’s safety and continuity of care (see Section 9). Withdrawal of consent does not eliminate outstanding financial obligations for services already rendered.
Consent for recording or observation
ABA therapy may involve video recording of sessions for the purpose of clinical supervision and quality assurance. Any such recording requires separate written consent from the Legal Representative and is protected under HIPAA. Recordings are not shared with unauthorized parties.
The minor as patient
In all matters related to consent and decision-making, the minor’s clinical welfare is the primary consideration. Florida law governs the extent to which a minor may independently consent to healthcare services. For ABA therapy, the Legal Representative is the decision-making authority on the child’s behalf.
7- Confidentiality & Medical Records
HIPAA protections
Blue Horizon is a HIPAA Covered Entity. All health information related to the minor patient — including diagnosis, treatment records, assessments, session notes, and any other Protected Health Information (PHI) — is protected under the Health Insurance Portability and Accountability Act (HIPAA). Our complete Notice of Privacy Practices is provided separately and available on our website and at each of our centers.
Use and disclosure of PHI
PHI may be used and disclosed without additional authorization for the purposes of Treatment, Payment, and Healthcare Operations (TPO) as defined by HIPAA. Any disclosure beyond TPO — including sharing with schools, non-treating providers, or family members not listed as Legal Representatives — requires a signed written authorization from the Legal Representative.
Mandatory reporting exceptions FL
Record retention
In accordance with Florida Statute §456.057, clinical records for minor patients are retained for a minimum of seven (7) years from the date of the last entry, or until the patient reaches the age of 18, whichever is later. Records are then securely destroyed in a manner that protects the privacy of the patient.
Access to records HIPAA
The Legal Representative has the right to access the child’s clinical records. Requests must be submitted in writing. Blue Horizon will respond within 30 days of receiving a written request. A reasonable fee may be charged for copies. In the event of a dispute between co-parents or guardians regarding access to records, Blue Horizon will follow applicable Florida family law and court orders.
8- Limitation of Liability & Disputes
Scope of clinical services
Blue Horizon provides evidence-based ABA therapy services as clinically indicated. We do not guarantee specific developmental, behavioral, or educational outcomes. The nature of ABA therapy and each child’s individual trajectory means that responses to treatment may vary. Our commitment is to provide competent, ethical, and individualized care to every client.
Limitation of liability
To the extent permitted by Florida law, Blue Horizon’s liability for any claim arising from the provision of services shall not exceed the total amount of fees paid by the Legal Representative for the specific services at issue. Blue Horizon is not liable for indirect, consequential, or punitive damages except where required by applicable law.
Internal complaint process
The Legal Representative is encouraged to bring any concern about services, billing, or conduct to the attention of center management before pursuing external remedies. Blue Horizon is committed to resolving concerns promptly and in good faith. Complaints may be submitted in writing to the center director at either location.
Governing law and jurisdiction FL
This Agreement is governed by the laws of the State of Florida. Any legal dispute arising from or related to this Agreement shall be brought exclusively in the courts of Lee County, Florida.
Dispute resolution
Before initiating formal legal proceedings, the parties agree to attempt resolution through mediation. This commitment to mediation does not limit any party’s rights under applicable Florida or federal law.
9- Termination of Services
Planned clinical discharge
Services may conclude when the child has achieved the clinical goals outlined in the treatment plan, when ABA therapy is no longer medically necessary, or when the child transitions to a different level of care. Planned discharge includes a transition period to ensure continuity of care and, where appropriate, referrals to other providers or community resources.
Termination by Blue Horizon
Blue Horizon reserves the right to terminate services under the following circumstances:
- Persistent outstanding balance not resolved after reasonable notice
- Repeated no-shows or cancellations that make consistent treatment impossible
- Conduct by the Legal Representative or accompanying individuals that compromises the safety of clients or staff
- Loss of insurance coverage without alternative payment arrangement
- Circumstances in which continued services would not be clinically appropriate or safe
In non-emergency situations, Blue Horizon will provide at least 30 days’ written notice of termination to allow the family time to transition care.
Termination by the Legal Representative
The Legal Representative may terminate services at any time with written notice. To ensure the child’s safety and wellbeing, we strongly encourage discussion with the clinical team before withdrawal to plan an appropriate transition. The Legal Representative remains responsible for outstanding balances at the time of termination.
Post-termination referrals ABA
Upon termination, Blue Horizon will provide a clinical summary and, where requested and authorized, referrals to other appropriate providers to support continuity of care for the child.
10- Modifications & Effective Date
Right to update these terms
Blue Horizon reserves the right to update or modify these Terms of Service at any time to reflect changes in law, clinical practice standards, insurance requirements, or operational policies. We will provide advance notice of material changes via email to the Legal Representative’s address on file, or through written notice at our centers.
Notification of changes
Updated terms will be posted on our website at bluehorizoncare.net with the effective date clearly indicated. Continued use of services following the effective date of any updated terms constitutes acceptance of those changes. If the Legal Representative does not agree to updated terms, they may terminate services as described in Section 9.
Questions about these terms
For any questions about this Agreement, please contact Blue Horizon at either of our center locations or by reaching out through the contact information on our website.