How to Recover Patients Dues to Maximize Your Accounts Receivables
Statistically, the moment a patient leaves a medical office without paying their outstanding bill, there is a 30% chance that they will never meet their financial responsibility. Unfortunately, for ABA therapists and other health care professionals, recovering these unpaid funds means spending significant resources, that go beyond financial considerations, and also include time lost in the red tape of the collections process. It is such a recurring trend, that many providers feel chasing these patients for their outstanding responsibility [...]
What Is CPT Code 99202 & How To Know When To Use It
Knowing when and how to correctly apply a CPT code is one of the most challenging aspects of mental health insurance billing. It typically requires the memorization and correct application of a staggering array of CPT codes. For a lot of solo practitioners, small practices, and ABA therapists, knowing exactly when to use a specific CPT code and in what situation can feel daunting. Yet accuracy is exactly how providers secure prompt payment from a “Clean Claim” that is [...]
Liability Insurance & Claims in ABA Therapy Help Guide You Should Know
Even the most diligent and forthright of ABA therapy providers still need to carry effective liability insurance both as a matter of law, as well as for sound business sense. Though just what type of liability coverage and type of claim can be somewhat complicated in certain situations. Especially with the advent of telehealth services and cybertherapy options. The fact remains that having a thoughtful liability policy in place not only protects your ABA therapy practice in a business [...]
Contracting vs. Credentialing ABA Therapy. What’s the difference? Which Comes First?
Contracting and Credentialing are critical components of any successful medical or psychological practice. It is especially important for small practices and Applied Behavioral Therapy practices. Though understanding the finer points of each, and which one needs to come first requires a little bit of a deep dive into some important details. What Is Credentialing? Credentialing plays a critical role in provider qualifications as well as reimbursement rates. Not to mention the licensing necessary to practice in most communities. It [...]
What Is The Birthday Rule For ABA Billing A Child’s Benefits?
Make sure you include Dual Insurance coverage - How do you determine which insurance plan is primary - Use the Birthday Rule Most insurance providers use a “Birthday Rule” as a key metric to efficiently coordinate a child’s benefits. In a case where a child is covered under both parents’ health plans, the birthday rule guides how the coordination of benefits works. The Birthday Rule is based on the primary coverage from the plan of the parent who has [...]
Top ABA Treatment Plan Items To Include For Maximum Payment
The term “Medically Necessary” plays a critical role in a lot of claims submitted to insurance companies, payer agencies, and public health institutions. Medically Necessary is broadly defined as “Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.” Medical Necessity Defined For ABA Therapy Service This large definition can be applied to medical healthcare services, diagnostics, and even mental healthcare therapy. In this [...]
Coordination Of Benefits In ABA Therapy. What Is It & Why Its Important?
ABA therapy is seen as the gold standard for treating individuals with Autism Spectrum Disorder, as well as many other serious mental health conditions. Many of these patients have a treatment support team that is overseen by a BCBA or similar expert in the ABA field. Of course, this also means that a lot of patients receiving ABA therapy need comprehensive coverage. Sometimes this can come from private or employer-sponsored insurance programs. Sometimes it comes from a combination of [...]
CAQH FAQ Guide For ABA Therapy Billing
A lot of ABA therapists and solo practitioners feel like they spend an uncomfortable amount of time working on paperwork and documentation when they would rather be focusing on their patients. The tedious nature of things like coding and medical billing documentation can rob small practices and solo ABA practitioners of too much precious time. In recent years CAQH has stepped up to help streamline these processes. Though how it works and how to become credentialed in their database [...]
Top HIPAA Violations ABA Therapists Should Be Aware Of
These days patient privacy is more important than ever. Especially in the mental health industry, where families, professionals, and individuals with autism spectrum disorder undergoing ABA therapy rely on a provider’s utmost discretion. The Health Insurance Portability and Accountability Act (HIPAA) was passed by the United States Congress in 1996 to ensure patient confidentiality. It specifically sets forth a series of critical regulations that impact providers of every discipline as well as health insurance companies. These regulations extend to [...]
How To Move Away From Manual ABA Billing
If you've been thinking about starting a new ABA therapy business as a solo practitioner or you have a thriving ABA therapy practice and you want to bring it fully up to the speed of 21st Century business, then you need to abandon the outdated paper or pencil form of documentation. This is an essential step toward a lot of other important innovations. Not the least of which is streamlining your medical billing practices for decreased errors, as well [...]
