What Navigating Credentialing Means For Your Business For many care providers, navigating credentialing is one of the more complex aspects of establishing and growing your practice. Credentialing is the process that the payer uses to verify that the practice or provider meets specific standards. The payer establishes those standards, which typically involves verifying that the provider has […]
Expectations When Outsourcing ABA Insurance and Billing | Your Missing Piece
What Expectations Should You Have For ABA Insurance Outsourcing Services? Making the decision to outsource billing and other insurance-related services opens the door for more time for you to manage your patients’ care and needs. It can often alleviate many of the frustrations you have as an ABA provider. Yet, it helps to know what […]
Handling An ABA Waitlist | Your Missing Piece
How To Manage An ABA Waitlist A waitlist is not uncommon for ABA providers. It occurs when you simply do not have enough available hours to provide service to the people requesting it. ABA services are in high demand, with a limited number of well-qualified professionals available to meet that demand. What’s more, those seeking […]
Keeping Up Telehealth Advising For ABA | Your Missing Piece
Telehealth For ABA Helps Maintain Critical Connections Many people who need ABA therapy benefit from coming into the office for care. Yet, telehealth for ABA has proven to be highly effective and improves access for many people who do not have another method of getting care. The pandemic helped shed light on the importance of connection […]
Obtaining ABA Authorization | Your Missing Piece
Guide To Obtaining ABA Authorization Whether you are an ABA provider that is in-network with an insurer or out-of-network, authorization for therapy is essential. Insurance companies require ABA authorization before they will reimburse providers for the therapy they deliver to the patient. Authorization may be a requirement, but it is not always a simple, straightforward process. Missing […]
How To Reduce The BCBA Insurance Billing Burden
Board-certified behavior analysts (BCBAs) provide guidance and structure to people with conditions such as autism spectrum disorder — often spending a significant amount of time and effort working closely with patients. Adding administrative burdens to their day-to-day work, such as BCBA insurance billing, is not the best use of their time, talent, energy, or focus. The […]
ABA Therapy Billing Codes
Applied Behavioral Analysis “ABA” billing and coding has changed significantly in the last ten years. The initial billing codes were undefined, leading to unreliable coverage and reimbursement. To create a standardized set of ABA CPT codes, the American Medical Association (AMA) established temporary Category III codes that were effective mid-2014. The Steering Committee for the […]
MUEs and NCCI: What are they, and how do they pertain to ABA billing?
MUEs can impact daily billing for ABA therapy. ABA providers should be familiar with the rules and regulations of CMS and NCCI.
ABA Audits: Is Your Practice Ready?
For an ABA practice, an audit from a health insurance company can seem intimidating, especially for smaller practices without the manpower or technology to handle bigger claims. Being audited by a health insurance company isn’t just a possibility — it’s a certainty. Health insurance companies use audits as a common strategy to ensure operations and claims are […]
HIPAA and Confidentiality for ABA and Behavioral Health Providers
All healthcare providers must be very familiar with the basics of HIPAA and state confidentiality regulations, as well as the requirements of their certification or licensure regarding confidentiality. In addition, as a practice, a comprehensive HIPAA analysis should take place regularly to ensure all required safeguards have been put in place to minimize risks.