Missing Piece Blog

Essentials About ABA Billing for ABA Therapy Practices

The healthcare landscape is constantly evolving, and your practice needs to stay informed and up-to-date with a variety of essential information about ABA therapy billing. If your practice handles its own ABA billing, it’s important that you understand the intricacies of this type of medical billing to ensure success.

In this blog, we will take a look at 10 crucial aspects that you should know about ABA billing services to optimize your operations and improve revenue management while devoting 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, and new codes are added to the database regularly. You must stay informed about the latest ABA-specific Current Procedural Terminology (CPT) codes. They are crucial in identifying and billing for ABA services.

There are two main groups of ABA codes: 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 own 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 that you have a record of 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 to 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 what is covered for ABA therapy can vary from company to company. It’s essential to verify every client’s insurance coverage before providing services to ensure that they are covered or that 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 payors 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. Accurately record session dates and times, the goals of therapy, treatment interventions used, and any outcomes. 

Not only does this support successful ABA billing, but it also helps to track client progress and inform future decisions on treatment.

Avoid common billing errors

Claim delays and denials can cause chaos for your revenue stream, many of which come down to simple billing errors. Incorrect data entry, missed submission deadlines, incorrect billing codes, duplicate claims, and failing 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, and this includes 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 attend some of the many industry conferences, webinars, and workshops that focus on ABA billing. This will help them to stay informed on the latest developments, as well as any changes in reimbursement and regulatory policies. Providing continuous training and education ensures that your company is well-equipped to keep up with accurate billing while providing high-quality ABA therapy services to your clients.

Outsource your ABA billing services

In-house ABA billing can be incredibly complicated and time-consuming. It’s worth considering outsourcing your ABA billing services to a specialized provider that is an expert in ABA-specific billing requirements.

Outsourcing to a company like Missing Piece can streamline your processes, take the administrative burden off of your staff, and help to improve your revenue management. We provide an all-in-one ABA billing solution that is scalable and flexible according to your requirements. 

By outsourcing to Missing Piece, you will reduce billing errors, speed up payments, and minimize billing costs. It also allows you to devote more time to providing your clients with the care they deserve.

Contact us to find out more about how we can streamline your ABA billing services today.