Missing Piece Blog

Common Misconceptions About ABA Therapy Billing

For ABA practitioners juggling a multitude of responsibilities, the notion that ABA therapy billing is a straightforward task that can easily fit into an already crowded schedule may be prevalent. However, this assumption is misleading, as a number of misconceptions about the billing process often complicate matters, leading to challenges that many practitioners face.

We unravel the complexities of ABA billing to gain a comprehensive understanding and address the various misconceptions surrounding the process.

What is ABA billing?

ABA therapy billing, on the surface, appears to be quite simple. It is the process of billing and collecting payments for the ABA therapy services that you provide. The reality, however, is much more complicated and time-consuming than many ABA therapy providers realize. In fact, this deceptive simplicity is just one of many misconceptions that people have about the billing process.

Common misconceptions

Here are some misconceptions that people have about ABA billing services.

1. It’s fast and easy

If you’ve ever looked into how to bill insurance for ABA therapy, you’ll understand that the ABA billing process is in no way easier than any other type of medical billing — which is known to be a challenging and time-consuming process. Thanks to constantly shifting billing requirements in the ABA industry, ABA billing codes, reimbursement rates, and authorization requirements change as federal and state legislation evolve, impacting the billing process. Because of this, billing for ABA has become far more complicated than simple data entry. It can end up consuming hours each day as you not only input and process the bills but also deal with issues that may arise during the billing process.

2. It’s costly to outsource

It’s easy to look at the cost of ABA billing and assume that either you or your in-house billing team can complete it more cost-effectively. Further investigation, however, reveals that the cumulative expenses associated with managing the billing process internally can escalate significantly over time.

First, you’ll need to factor in the various software tools used to process your billing correctly. Today, the majority of these tools run on individual licenses, so you may need to pay for multiple licenses, depending on your practice. While the monthly cost appears reasonable, you’ll end up spending thousands of dollars over time. 

This is particularly true as your practice expands, as many of these apps work off scaled pricing that becomes increasingly more expensive with each client you add to the system. Add in the possibility that you decide to purchase another license (or licenses) so that another member of your practice can assist with billing, and it’s easy for the cost of software to snowball quietly far beyond your original expectations.

Then there’s the unspoken cost of only having a certain number of hours available in your day, which we already touched on in the first myth. Even if you give your patients 100% of your attention during your business day, billing still needs to be done. That means precious hours that could be spent with friends and family, doing chores, or even just relaxing after a hard day’s work will instead have to be spent ensuring your billing is processed correctly. 

Alternatively, you might consider allocating some time within your standard working hours for this task. But this strategy reduces the time available for client sessions, negatively impacting your potential income. Additionally, the extra time spent resolving billing mistakes, denials, and communicating with patients about billing issues — not to mention the associated stress — makes the prospect of outsourcing your billing increasingly appealing from a financial standpoint.

3. An in-house billing staff member or team is quicker or more cost-effective

If you’ve recognized the complexities of ABA therapy billing and opted to hire dedicated personnel to address billing matters, you’ll undoubtedly see an improvement in the efficiency of the process compared to attempting to manage it alongside your business on your own.

Note, however, that there are many challenges and costs associated with running your own in-house billing department as well. We discussed one of these issues in our previous misconception, which is the (potentially escalating) cost of the software needed to process billing in-house, either by you or your staff. Then you need to factor in other expenses like physical space for your team to work, the time and energy you’ll need to invest to quickly replace staff if someone resigns (as billing is a vital role in any practice), the possibility of hiring an underperforming or under-skilled employee, ensuring your team is given the time to remain up to speed on the latest billing practices, codes, and legislation, and other issues.

Ultimately, it will likely prove challenging for your billing staff member or team to match the resources and expertise that a dedicated and quality therapy billing provider offers.

The benefits of outsourcing

Now that we’ve debunked some of the myths around medical billing, it’s time to discuss the benefits and expectations when outsourcing ABA insurance and billing. Here are some of the most prominent reasons to outsource medical billing and why you might want to consider outsourcing this part of your practice:

  • Access to the latest billing information
  • Faster payments thanks to a dedicated revenue collector
  • Improved collection of payments thanks to a dedicated revenue collector
  • Eliminates the need to invest in expensive in-house billing tools
  • Allows you to focus your time on your patients

How to choose the right ABA billing company

If you’ve decided to outsource your organization’s billing, you need to know how to choose the right provider. Here are some tips to help you find the right company to meet your practice’s needs:

  • Check to see if they have extensive experience and a good reputation.
  • Find out how many staff members the organization has.
  • Ask to see their staff members’ qualifications.
  • Enquire about a detailed breakdown of the cost of their service so that you know exactly what you are getting, such as denial management and deadline agreements.
  • Make sure the company is using the latest billing software.
  • Find out if they can scale to meet your needs as your practice grows and how quickly they can do that.
  • Look for reviews from other ABA practitioners.

Simplify your billing processes with Missing Piece

As an ABA practitioner, your focus should be on providing your patients and their families with the best possible service, rather than spending your time trying to figure out all the ins and outs of billing. Thankfully, Missing Piece can help. As a provider of turnkey ABA billing services, we handle a variety of different areas of billing, including ensuring billing compliance, the administrative aspects of billing, and access to the latest billing expertise. Contact us to learn more about how Missing Piece can assist you.