Missing Piece Blog

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 better option is to outsource BCBA billing services to an expert. However, before deciding to do so, BCBAs should know what to look for in a third-party billing service to ensure streamlined processes and efficient services.

What should a BCBA look for in a billing partner?

Because a BCBA billing service needs to support a complex area of insurance claims management and other billing services, selecting a company that understands how to bill insurance as a BCBA is a critical investment. When outsourcing insurance and billing, expect a third-party provider to have a good depth of understanding of the diagnosis, treatment, and supportive services provided by the BCBA. Here are some of the critical services this type of organization offers.

Medical billing accuracy

Medical billing accuracy is not as simple as it seems. However, any third-party provider for BCBAs must be able to verify accurate patient medical billing data. The provider should also ensure that all industry standards in the field are maintained (including all compliance requirements) throughout the claim submission process.

While complex, these providers should see that the process remains efficient. Patients must receive the care they need as soon as possible while the provider receives payment promptly for all services rendered to that patient.

Professional claims management from start to finish

Professional claims management encompasses more than just knowing the proper BCBA billing codes. A third-party provider must always manage the entire claims process professionally and comprehensively. That includes coordinating with insurers to confirm all claims are accepted, often providing verification of benefits in advance of coordinated care. Third-party claims management should also manage the process until payment is made, providing follow-up services with insurers as needed. A professional third-party service will also know the proper BCBA billing codes, removing any billing-related stress.

Denial reduction to streamline revenue

One of the most time-consuming and frustrating aspects of billing is denials, especially as a result of simple coding mistakes. As such, the services provided and the best practices employed by the billing provider should directly lead to a reduction in the number of claim denials for the practice. 

Management of patient billing

Managing the insurance billing process is one step. BCBA billing teams are also required to manage patient billing for any remaining cost or for full payment when a person lacks proper insurance coverage. This includes making sure patient balances and accounts are accurate and carefully monitored.

This should involve services for the management of co-payments, co-insurance payments, and invoice management. A comprehensive, clear, and well-managed process can eliminate surprises that often drive patients away from obtaining the services they need.

Complete RCM services

Revenue cycle management (RCM) is an industry standard in the billing process. It enables practices to better manage the claims they have while also working to collect payment for each of the services the BCBA renders to clients. At the same time, it safeguards that all revenue coming in is properly maximized, enabling the practice to grow and meet or exceed financial goals.

Working with in-house staff

For those BCBA providers that already have an in-house staff delivering administrative services, choose a medical billing provider that can work in conjunction with staff (rather than separately) to manage the billing process efficiently.

Moving medical billing to a third party allows staff members to focus more on improving relationships with patients, meeting in-office demands, and providing supportive services to BCBA providers — often enhancing the quality of patient care.

Benefits of using a third-party service for medical billing

Making use of the services of a third-party provider offers many benefits, including:

  • Maximizing the reimbursement received for all services rendered
  • Making sure more time is spent with the patient than on billing requirements
  • Expertise in all aspects of revenue cycle functions
  • Minimize payroll costs for maintaining an in-house billing department
  • Using transparent, effective, and highly specialized medical billing in the BCBA sector

Find out how Missing Piece can assist you

Discover how Missing Piece can provide customized, comprehensive support to your patients with adequate BCBA billing rates while alleviating the time pressure on the work you do. Contact us today to learn more.