Managing ABA authorizations tends to be one of the more common pain points with ABA billing. Despite the hurdles that come with this process, authorization management is necessary to service your patients most effectively and to increase financial efficiency within your organization. Two areas to watch out for when it comes to authorization issues are over-utilization and under-utilization. Over-utilization can result in services being provided that cannot be collected. On the other side of the coin, under-utilization of authorization can result in patients not receiving the full medically necessary services they are approved for; and to a further extent, continuous under-utilization holds the potential for reductions in future authorizations. To help reduce and even eliminate authorization issues such as these, there are three focuses we encourage you to keep at the forefront of your thought process: Consistent monitoring, clear communication, and schedule accessibility.
The most important key to successful authorization management rests in actively monitoring your active authorizations. To maintain a current understanding of authorization usage, weekly status check-ins are imperative. We would encourage you to designate a single team member to be responsible for monitoring authorizations, maintaining awareness of usage, and reviewing the start and end dates. If your organization works with a revenue cycle management partner, ABA billing company, or have specialized management software, this may be a service that you can take advantage of. Maximizing begins with monitoring.
In the same way that the act of monitoring can lead to successful authorization management, communication is another essential factor. Frequent communication should take place between all parties involved to ensure that neither over-utilization nor under-utilization pitfalls come into play. Including therapists, BCBA(s), administrators, caregivers, family members, and internal teams to be part of the bigger conversation is a great way to ensure everyone is on the same page. If a family is having trouble maintaining a consistent schedule, this could prevent the patient from receiving the full services for which he/she is approved. Clear communication with the family may help address attendance issues and improve their understanding of the importance of utilizing the authorized services.
A final key to prioritize when managing authorizations–and one that goes hand in hand with the communication aspect–is scheduling. If it is possible, give your scheduling department access to authorization usage information so that adjustments can be made in accordance with timeframes and usage. Open lines of communication between the billing team and scheduling department will help ensure that scheduling complies with ABA billing rules, requirements, and other authorization usage factors.
Despite more common difficulties that come with the authorization process, prioritizing these three focuses can help reduce pain points and lost revenue from developing into larger issues. Consistently monitor. Clearly communicate. And stick to your schedule.
If your organization is looking for a ABA billing company to help alleviate the burden of managing authorizations, please contact Missing Piece Billing and Consulting today at email@example.com or 765-628-7400.