Applied behavior analysis (ABA) therapy is an essential tool in the lives of so many individuals. As ABA becomes more and more common practice, the number of clients that you need to bill will increase, making your workload heavier and the need to streamline your processes more pressing. If you don't keep a close eye on your client numbers and billing practices, you'll find yourself in a sticky situation before you know it!

ABA billing can be fraught with difficulties and complications. It is a complex matter to be sure, but we're here to offer a little help! Getting your clients billed and getting those payments in record time can only be helpful in your practice. We have some tips and tricks that will go a long way to streamlining your work processes, getting your bills out as fast as possible, and also getting clients to pay as quickly as they are able to. Let's take a closer look.

A few things to note

Before we begin, there are a few things that should be of special interest and importance to you throughout your billing process. The role of revenue cycle management cannot be understated here: from first contact all the way up to the point where the full amount of the bill lands in your/your client's bank account. All the way through this process, the revenue cycle is hard at work. The following codes are an all-important part of this cycle:

97151 - Behavior Identification Assessment  

0362T - Exposure Behavioral Follow-Up Assessment  

97155 - Adaptive Behavior Treatment w/ Protocol Modification  

97156 - Family Adaptive Behavior Treatment Guidance  

97157 - Multiple Family Group Adaptive Behavior Treatment Guidance  

0373T - Exposure Adaptive Behavior Treatment with Protocol Modification  

97152 - Observational Behavioral Follow-Up Assessment  

97153 - Adaptive Behavior Treatment by Protocol  

97154 - Group Adaptive Behavior by Protocol  

97158 - Adaptive Behavior Treatment Social Skills Group  

Utilizing all of these codes and understanding them properly is essential to billing accurately and ethically and getting your clients to pay on time.

Soft collections

After you send a bill, the first follow-up is referred to as "soft collections."  Set up a phone call to each client and to funding sources (who have no motivation to pay on time) early in the week after billing to ensure that they have received the bill, that they understand all the charges, and that they are able to pay on time. This is a valuable step in staying on top of collections and also in ensuring that the client who has been billed is doing okay in terms of understanding and paying the bill. Clients will be far more likely to communicate with you in the event of an issue if they know that you are caring and there to help if the need arises.

Sometimes the reason for a bill being unpaid during this period is as simple as a missed or incorrectly labeled email, so following up clears up all confusion and gets those bills paid.

Payment application - The basics

There are many tasks that can be taken care of immediately and on a consistent basis that will keep bringing in cash flow on time.

• The staff member responsible for applying payments must consistently notify billing/collections if payment is not made in a timely manner.

• You must either use practice management software or an accurate Excel/Google Docs spreadsheet to track the reconciliation of bills and payments. Do not leave this to chance! Your practice will grow as more and more people discover ABA therapy; don't wait until you are overwhelmed to implement this system.

• Be sure of which billing methods are linked to which funding sources. If your billing fee is scheduled and an adjustment comes your way, take a deep breath and don't panic! This was always going to happen at some point. Billed charges will equal the fee schedule, and allowed charges will equal the contracted rates.

• Set up processes that help you to reconcile what's on your software to the total of checks applied. It's small things like this that keep the big processes flowing smoothly come month or quarter end.

• If an overpayment comes in, set up a notification system on your software or red flag in your sheets and pass it along to whoever should be investigating immediately. If you leave it be, the funding source will notice in the future and underpay by the same amount, which will completely mess up that month's reconciliations.

Collections

Here is where the heavy lifting comes in.

• When you make a call on a current issue, look over the whole account to make sure nothing else is amiss.

• In-person collections are more likely to get a result than an automated system, so always make the call.

• Be assertive when you call but not aggressive; people are more likely to respond well.

• Allocate a few hours every week to resolve old balance and collection issues.

• Always keep detailed notes on all calls and accounts. Schedule a follow-up call if you need to.

• If all efforts fail, report this and file an appeal in a timely manner. The more information you can provide here, the better.

Wrap up

Keep on keeping on with these simple processes and procedures, and you'll have a steady cash flow coming in all the time!