The healthcare landscape is constantly evolving, and your practice needs to stay informed and up-to-date with a range of information regarding ABA therapy billing — from ABA insurance codes to billing software. If your practice handles its own billing, it’s essential that you understand the intricacies of this type of medical billing to ensure success.
In this blog, we’ll examine 10 crucial aspects of ABA billing that you should know to optimize your operations and improve revenue management while continuing to devote the highest-quality care to your clients.
Stay informed about current ABA billing codes and categorization
Billing codes are the cornerstone of successful ABA billing practices, and new codes are added to the database regularly. You must stay informed about the latest ABA-specific Current Procedural Terminology (CPT) codes, which are crucial in identifying and billing for ABA services.
There are two main groups of codes in behavioral health services: treatment codes and assessment codes. The assessment codes cover a client’s initial evaluation and assessment, while the treatment codes cover the actual ABA therapy sessions. Each category has its specific guidelines and codes, which are essential to understand to accurately and successfully bill for services rendered.
Don’t forget about time-based codes
Another aspect of billing codes to remember is that they are based on the time spent with the client. These codes cover increments of 15 minutes, and it’s important, as a medical biller, that you record the time spent with the client to bill accurately with these time-based codes.
Work closely with certified ABA therapists
Collaborating with experienced, certified ABA therapists will help minimize billing errors and ensure that all services are accurately documented. ABA therapists are also knowledgeable about billing codes and other aspects of billing and could provide guidance and valuable insights when billing for their services.
Verify insurance coverage, diagnosis reports, and referrals
Every insurance provider is different, and the coverage of ABA therapy can vary greatly from company to company. It’s essential to verify every client’s insurance coverage before providing services to ensure they are covered or you don’t exceed the maximum benefit threshold.
Medicaid requires a referral for ABA therapy cover, so ensure that you accurately note who the referring professional was before sending in a claim.
All providers require a diagnosis report that meets the DSM5 criteria. Providing this information will help to avoid claim delays and denial.
It’s also important to stay up-to-date with reimbursement rates and guidelines that individual insurance providers set. These can vary widely, and you should understand the intricacies of the different companies to ensure accurate and fair reimbursement and that claiming from them is financially sustainable.
Ensure accurate and detailed documentation
Successful ABA billing comes down to accurate, detailed documentation and record keeping. Establish a robust system to record and store patient information, therapy sessions, and progress details. Record session dates and times, therapy goals, treatment interventions used, and any outcomes. Not only does this ultimately save time on ABA billing, but it also helps you track client progress and inform future treatment decisions.
Avoid common billing errors
Claim delays and denials can disrupt your revenue stream, and many are caused by simple billing errors. Incorrect data entry, missed submission deadlines, incorrect billing codes, duplicate claims, and failure to provide referrals are some of the most common billing errors that lead to delayed or denied claims.
Continuous medical billing and coding training
The medical field is ever-evolving, including ABA and its billing requirements. It’s essential that you invest in ongoing education and training in medical billing for your staff so they stay informed of the latest industry standards and developments.
Staff should regularly attend industry conferences, webinars, and workshops on ABA billing. This will help them stay informed on the latest developments and any reimbursement and regulatory policy changes. Continuous training and education ensure that your company is well-equipped to keep up with accurate billing while providing high-quality ABA therapy services to your clients.
Streamline and simplify by outsourcing to a reputable medical billing service
In-house ABA billing can be incredibly complicated and time-consuming. It’s worth considering outsourcing your ABA billing to a specialized provider with expertise in ABA-specific billing requirements.
Outsourcing to a company like Missing Piece can streamline your processes, relieve your staff of administrative burdens, and improve your revenue management. We provide an all-in-one ABA billing solution that is scalable and flexible to your requirements.
Outsourcing healthcare medical billing jobs and tasks to Missing Piece will reduce billing errors, speed up payments, and minimize billing costs. This will also allow you to devote more time to providing your clients the care they deserve.
Contact us to learn how we can streamline your ABA billing services today.