Top Medical Credentialing Mistakes You Should Avoid
Maintaining the highest quality of care for all patients in the United States requires many facets and attention to detail. One of the most important of all these quality care standards is medical credentialing. It plays a role not just in making sure that patients are seeing the best possible provider for their condition. It also is crucial in claim submission, determining reimbursement rates, and ensuring that you or your practice is adequately compensated by various medical insurance providers. [...]
ABA Practice Audit Prevention Tips
Applied Behavioral Analysis (ABA) therapy is an increasingly popular field in the mental healthcare industry. ABA providers often have to work intensively with insurance carriers to ensure their patients are qualified for various treatment strategies. This level of interaction and scrutiny means that as an ABA therapist you’re likely to go through several audits in the course of your career. Even though auditing for ABA practices is no longer a probability but a certainty. While it’s a natural part [...]
Improving ABA Therapy Utilization Review Processes
Applied Behavior Analysis (ABA) therapy is seen as the gold standard for treating individuals with autism spectrum disorder as well as many other behavioral conditions within the mental health sphere. It’s currently estimated that approximately 50% of currently practicing BCBAs have received their certification within the last five years. While this is certainly something to celebrate for all the patients who need ABA therapy to live their best possible lives, it also means that there are a lot of [...]
How To File An ABA Therapy Claim
Applied behavioral analysis therapy (ABA) practices often find themselves repeating the same traditional claim submissions formula that they were taught back at the university level. Though sometimes consistency can give an ABA provider a false sense of security against claim rejections, denials, and potential payer institution audits. More than one ABA therapy practice that made a change in their claim submission practices found that their previous stagnation was directly contributing to a loss of revenue or unnecessary delays in [...]
Letter of Interest for Insurance Credentialing Tips
A lot of small practices and solo practitioners send a letter of interest to an insurance carrier in hopes of getting paneled with them, as a credentialed in-network provider. In a lot of ways, a letter of Interest is very similar to a cover letter though there are some significant differences. With a cover letter like you might write when applying for a new job, you’re really only sending a small amount of information. Usually, a resume or an [...]
My ABA Billing Was Underpaid. What Should I Do?
It's an unfortunate reality that most ABA therapists experience occasional underpayments for a claim that was submitted in good faith. A lot of these cases occur when a health insurance company fails to accurately reimburse a provider the full requested/contracted amount due to a medical coding error, missing information, or an outright miscalculation by the insurance company. Compounding this hassle is that some sizable underpayments can lead to long-term financial problems for an ABA practice. Especially if the issue [...]
How To Prevent Patient Debt With RCM
It’s not uncommon for patients to be financially stressed to the point where they cannot feasibly pay their medical bills at the time of service. This means that the payment ends up getting delayed. Sometimes it can be delayed so much that it turns into an outright case of non-payment. The patient might even stop receiving necessary care. This pattern of delayed payments can even end the long-term relationship between the patient and the provider. Thus, leaving the patient [...]
Differences Between Behavioral Medical Billing VS Conventional Medical Billing
Behavioral medical billing can be frustrating at times, as it tends to take up a significant amount of time, and its arcane nature can sometimes get in the way of the time you would otherwise spend treating or recruiting new patients. At the same time, a lot of insurance carriers are also prone to using incongruities in the mental health industry to deny certain claims or submit a reduced underpayment. Whereas conventional billing practices are strictly codified. Many of [...]
How To Manage ABA Therapy Practice Remotely
Remote mental health services were already transitioning to more and more remote services before the COVID-19 pandemic. The rapid advance in remote technology and communication systems has opened new doors that ABA therapists around the world have been using to stay connected with the patients who rely on their care. Many patients have a support team already in place to facilitate the use of advanced communication technology. This has the net benefit of helping ABA therapists connect with more [...]
Insurance & Billing Guide For New Speech-Language Pathologists
Speech-language pathologists are often called upon to provide services to a wide range of patients in a variety of venues. This includes working with schools and other educational institutions as well as working with patients in a clinical setting or in some cases from the comfort of their own homes. In recent years remote services have started becoming popular for speech-language pathologists who work with patients in remote, rural locations. Where travel is prohibitive. This can create challenges in [...]
