Missing Piece Blog

ABA Billing in 2021

ABA and Behavioral Health Billing in 2021

Looking back over the past twelve months, 2020 has been one of the most challenging years for healthcare providers and the people they serve on numerous levels: mentally, physically, emotionally, financially. While we all continue to navigate what the future will look like day by day, our commitment at Missing Piece to serve you and act as a resource remains the same. We’ve compiled a list of best practice financial recommendations as we all begin to look towards what 2021 holds. Take a look and see if there are additional ways you can maximize your organization’s revenue potential in 2021.

Obtain New Insurance Cards

Providers and billers should make a point to get current copies (front and back) of all insurance cards. Up to date cards are crucial for obtaining accurate eligibility and benefit verification, as well as claims submission addresses. Demographic information should be updated in all EMR/EHR systems to ensure clean claim submission. 

Review Eligibility and Benefit Information and Review Details with Patients

Each patient, both existing and new, should undergo a complete comprehensive eligibility and benefits review for each insurance policy. Verification of available benefits, limitations, and financial obligations should be documented, and communicated to the patient’s family and treatment team. This information will help families plan for payments accordingly, along with understanding their responsibilities. 

Review Patient Financial Agreements

As a new year is on the horizon, providers should review financial agreement templates, updating as needed with new policies and fee schedules. This updated financial contract should then be presented and explained to patients and their families for signature.

Payment Plan Documentation

Whether you already have a payment plan in place or are considering establishing one for your patients in the coming year, we would encourage you to review your documentation process and ensure everything is up to date. Having current and signed copies of all your contract agreements on file is extremely important; handshake agreements won’t cut it in our litigious society.

Offering Online Statements, Payment Portals, and Credit Card Options

With advancements in payment option technology, the medical world has seen significant increases in collections and promptness if electronic statements and online payment options are offered. If this is not a feature currently being provided, it could be advantageous to consider investing in setting this up. At a minimum, providers should offer secure credit payment options — processing must be PCI (Payment Card Industry) compliant to avoid security violations.  Additionally, credit card fees should be taken into consideration when making this decision. 

Reach out to Patients with Outstanding Balances

As the year is ending, providers should review any outstanding balances and coordinate payment terms with patients for remaining account balances.

Review Standard Fee Schedule

Each year, providers should review their standard fee schedule – sometimes referred to as a “rack rate” – and establish their costs of services. It is highly recommended that all payers are billed at the same rack rate regardless of their reimbursement or usual and customary rates. As a good business practice, providers should evaluate their cost of doing business and re-establish their rates on a yearly basis. 

Review ABA Billing Policies and Procedures

On an annual basis, if not more frequently, business operations teams should complete a comprehensive review of billing policies and procedures, along with business practices and key performance indicators – making improvements as needed. During these evaluations, providers should consider the benefits of outsourcing their ABA billing and revenue cycle needs to help elevate their business’ productivity. Outsourcing these services will free up the time to focus on patient needs and increase cash flow and revenue cycles. 

Negotiate Rates with Payers

Providers should be familiar with their contract terms and fee schedules with every payer.  Payers may negotiate rates with providers.  If available, a provider should request a rate review when their organizational fee schedule is updated to help maximize revenue.   

For more ABA billing collection tips and insights, contact

Missing Piece Billing and Consulting at

765-628-7400 or weare@yourmissingpiece.com