Medical records are a critical service piece for both patients and providers. These records document the health, well-being, medical needs, plan of care, medical necessity and treatment(s) rendered for a patient during their time with a clinician or therapist. This information is frequently reviewed by internal and external medical professionals, patients, and third-party payers. Failure to document information correctly can not only be detrimental to a patient’s care, but it can greatly impact payment for services.
Month: May 2024
State Insurance Mandates
Over the past 20 years, all U.S. states have adopted legislation that compels health insurance providers to cover treatments and services related to the care of autistic children. This encompasses a wide range of services, from physical and behavioral healthcare to various therapies like speech, occupational, and physical therapy, in addition to applied behavioral analysis […]
ABA Audits: Is Your Practice Ready?
Health insurance companies use audits to ensure clinical and billing requirements are met. Even if an ABA provider is taking all the necessary steps to ensure that they are compliant, a health insurance company may still trigger an audit to ensure no issues are found. An audit may be stressful for the owner of an […]
ABA Claim Submission Dos & Don’ts
Prior to 2019, ABA therapy providers encountered significant obstacles in billing as they were forced to make use of generic billing codes to process ABA claims. This stipulation caused a number of issues for ABA practitioners and others involved in ABA claims processing. Although 2019 saw the introduction of specialized CPT I and CPT III […]
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. […]
Contracting and Credentialing for Beginners
Contracting and Credentialing are the first steps in becoming in-network with a payer. Let Missing Piece Billing and Consulting help your behavioral health or ABA therapy practice start things off correctly with the insurance companies.
Common Misconceptions About ABA Therapy Billing
For ABA practitioners juggling a multitude of responsibilities, the notion that ABA therapy billing is a straightforward task that can easily fit into an already crowded schedule may be prevalent. However, this assumption is misleading, as a number of misconceptions about the billing process often complicate matters, leading to challenges that many practitioners face. We […]
Managing Your ABA Authorizations
Managing ABA authorizations tends to be one of the more common pain points with ABA billing. Learn three tips to help.