Medical Billing and CodingNavigating ABA Billing Challenges: Our Tips for Success

Applied Behavior Therapy isn’t as established as many other medical and mental health therapies. Since the industry is, relatively speaking, a fairly new one, the goalposts are often moving as it finds its feet and expands its practices. The financial hardship of life during the time of COVID has had long-lasting impacts on many businesses, and this can’t be underestimated as a factor in ABA practices either.

Many providers have spent years dealing with their ABA billing in-house, but if they want to use their resources to the best of their abilities and maximize their time, the best thing to do is to start shifting to billing software designed particularly for the ABA industry. Apart from billing software, there are several things you can do when you bill ABA clients that will help keep your eye on the ball and get the most possible value for your client’s money. Let’s have a closer look.

Audit

Before you can even begin understanding how to improve your billing methods, you need to audit your processes, software and systems. If you’re going to improve, you have to understand where things are going wrong, right? An integral part of getting your business processes as automated as possible is ensuring the EMR system you have is top-notch. You need to be able to store your client’s PHI securely and access all of the online scheduling. Using systems that allow for scheduling lets you access data that will flow into your system to generate claims and bills according to services listed as rendered. Audit the number of hours spent on manual billing and figure out how much that time costs. This time could be spent doing anything from looking up demographic information, including claim information or calculating service units.

Get The Whole Company On The Same Page

In any business, few things are as important as having the entire organization on the same page. What we mean by that, in this instance, is that there should be standards for billing that apply company-wide. These standards should be applied with equal force in all areas of the company, or things will get messy very quickly. Breaking down your revenue cycle into manageable chunks will help you implement reasonable standards. Here are some categories to consider:

• Benefit verification
• Billing and patient intake documentation
• Auditing and scrubbing of claims
• Posting payments
• Billing patients
• Reporting incomplete or unverified appointments
• Rejection management
• Reporting
• Tracking documentation

Have One Point of Contact

If you’re changing your billing procedures to newer systems, there’s likely to be at least a small amount of chaos and many questions. Rather than having the whole office ask each other questions that may not be answered well, have one person manage the shift to the new billing process. Have them take a course, if need be, on the new software to answer any questions that may arise and help smooth the transition.

Find A Billing Solution With A Clearinghouse

If you are automating to use your time and effort better, you might as well go all the way! Ensure your new software has a clearinghouse: a built-in connector to the system that lets you submit e-claims and tracking. What should you look for in a good system?

• Ability to handle complex and unique billing scenarios
• Full automation
• Clearinghouse system
• Full reporting that includes rate comparisons, under or over payments and denials
• Denial tracking
• ERA connection for payment posts
• Easy payment features for the client

Implement KPIs to Determine Success

If you don’t know and understand the Key Performance Indicators for the ABA industry, how can you bill properly? Here are some of the chief indicators for the ABA industry.

• DRO or Days In Revenue Outstanding. This indicates revenue cycle efficiency.
• Rejection Rate. This helps to measure coding and compliance with payor expectations.
• Net Collection Rate. This measures your practice’s effectiveness at collecting payments for services rendered.
• Denial Rate. This measures your practices’ ability to offer accurate claim payment and claim auditing/ scrubbing.
• Total AR/ 90 Days. This indicates revenue cycle effectiveness when collecting from payers against your AR.

Wrap Up

It is tricky navigating an industry whose boundaries are constantly expanding. Your job is to ensure all receivers of services are paying for services rendered and getting the most out of their claims on medical aid. You’ll do perfectly if you keep up with the latest technology and stay ahead of the curve.

This is a sponsored post