Missing Piece Blog

CEUs & Maintaining BCBA Certification

Board Certified Behavioral Analysts (BCBAs) are integral to ABA therapy and the wider behavioral analysis framework. BCBA certification is internationally recognized and sets the standards for ethical and professional conduct in the industry.  ABA therapy is constantly evolving, and therapists must keep up-to-date with the latest techniques, research, and best practices to stay on top […]

Payment Posting in ABA Therapy

Weak billing processes cost medical and ABA therapy practices billions of dollars a year in the United States. Medical payment posting is an integral factor in ensuring that practices have a strong cash flow and seamless revenue cycle management.  In this blog, we’ll examine what it entails, how to post payments in medical billing, the […]

How Do Out-of-Network Benefits Work?

Applied Behavior Analysis (ABA) therapy is a crucial intervention for autistic children or those with similar developmental disorders. However, understanding the nuances of medical billing can be complicated for both providers and clients.  Insurance is always a tricky industry to understand in-depth and is also one of the most common confusion areas in ABA medical […]

Types of Rejections in Medical Billing and How To Avoid Them

Claim rejection is one of the most frustrating things for medical and healthcare providers. The rejection of a claim can happen for many reasons, and while one here and there might not seem like a big deal, the impact of rejected claims can be significant for a practice. Let’s delve into the most common reasons […]

Improving Scheduling & Authorizations Management In ABA Practices

Proficient management of medical authorizations is crucial for both financial stability and client progress in the field of ABA therapy. ABA practices frequently face issues with authorization management, such as under- and over-utilized authorizations, which can significantly affect revenue and client outcomes. Additionally, it can harm client outcomes by preventing learners from accessing other necessary […]

How Staff Turnover Impacts Credentialing

Staff turnover is a prevalent challenge across a number of industries, and the healthcare sector is no exception. For autism therapy providers, the repercussions of high turnover rates are especially significant, being that it is such a specialized industry. One of the most critical areas affected by frequent staff changes is credentialing — a fundamental […]

How Medicaid Rates Impact ABA Therapy

Autism Spectrum Disorder (ASD) represents a complex developmental condition that involves persistent challenges in social interaction, speech, and nonverbal communication, which can be accompanied by restrictive behaviors. The care and therapeutic interventions for individuals with ASD require a tailored approach, one that often includes Applied Behavior Analysis (ABA) therapy, among other services. For many families, […]

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 […]

Relative Value Based Reimbursement

The Resource-Based Relative Value Scale (RBRVS) represents the foundational payment model utilized by the Centers for Medicare & Medicaid Services (CMS) and the majority of other payers. While still new to ABA therapy services, this system is rooted in the philosophy that reimbursement should align with the underlying costs of providing such services. The RBRVS […]

How-To Guide for Processing ABA Insurance Claims

Despite recent developments in the healthcare industry that now ensure that ABA therapy is covered by medical insurance, it can still be challenging for ABA practitioners to claim for their services. It’s crucial to bill the correct ABA codes based on the delivered service and use the correct modifiers to ensure a one-to-one match with […]