5 Things to Keep in Mind When Choosing an ABA Therapy Billing Company

Insurance billing for ABA (applied behavior analysis) is often challenging for most therapists. There are many codes to track, with modifier variations and the POS based on provider credentials, state, plans, and telehealth-related guidelines. Each state has different protocols and portals for Early Intervention Programs (EIPs) and Medicaid. That’s why discerning therapists outsource their ABA therapy billing to an RCM service provider to offset the workload and allow themselves to focus on their clients.

But not all ABA RCM service providers are alike. You need to make sure you’re choosing an experienced, trustworthy, and reputable company that can consider your best interests. Keep these five things in mind when selecting an ABA therapy billing company:

1. Ensure their experience

Find out how long the company has been providing the service and who their clients are. Choose a HIPAA-compliant service provider with a professional ABA coding team that is always up-to-date with the latest developments in therapy billing codes, regulations, coverage, and modifiers. They can streamline your billing processes and tackle the challenges preventing efficient and timely collections.

2. Explore their technologies

Consider an ABA therapy billing company with ABA-specific software solutions that combine robotic process automation and machine learning to address your billing pain points. These solutions can help conduct audits to minimize denials while continuously overseeing payments and contracts to ensure accurate payments.

3. Makes sure they are up-to-date

ABA therapy billing codes change from time to time, so the company’s team needs to be constantly updated. They must implement the changes related to two revised Category III codes and eight new Category I codes.

4. Ensure an understanding of Medicaid ABA billing

Many providers find it challenging to bill ABA services via Medicaid. Choose a billing company with extensive experience in successfully submitting ABA-specific claims to Medicaid. That way, you can be confident in their capabilities and knowledge of the intricacies of billing mandated services and maximizing reimbursement.

5. Look for end-to-end services

Some of the best ABA therapy billing companies can be your one-stop source for all the services and expertise you’ll need to enhance your revenue cycle management. These include payer contract management, medical coding, charge entry, prior authorizations, clean claims, and prior authorizations. You can also leave AR clean-up, denial management, AR management, automated patient statements, and payment posting to them.

Plutus Health Inc. is a 15-year-old full cycle RCM firm specializing in medical coding, medical billing, payment posting, denial management, credentialing, prior authorizations, AR follow-up & out of network negotiations for both medical and behavior