Professional ABA Therapy Billing Services

Boost revenue and spend more time with clients by using Pharmbills’ specialized applied behavioral analysis billing services

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How our ABA Therapy Billing Services Can Help

Prior Authorization

One of the most time-consuming aspects of ABA therapy billing is prior authorization. Our ABA billing specialists will set up a streamlined process so you can move clients from intake to approval to therapy provision as efficiently as possible. This means you will spend less time on non-billable administration and more time delivering care that makes a difference.

Claims Management

Due to the varying requirements between payors, many ABA therapy providers face significant challenges with reimbursement. We’ll handle all aspects of ABA insurance claims, including collecting relevant CPT codes, claims submission, tracking, and denials management. With Pharmbills at your side, you can focus on delivering care while we look after all aspects of claims management.

Data Tracking Analysis & Entry

Maximizing ABA therapy billing requires a large amount of data collection and data entry. Our team can help you set up efficient processes to collect, enter, and manage the data required for efficient ABA claiming. We’ll also provide regular data analysis and reporting, giving you full transparency into the financial performance of your business.

Accounts Receivable & Payable

Handling tasks related to managing accounts can reduce valuable billable clinical time for ABA therapists. Our affordable and efficient outsourced accounts management services provide an end-to-end solution for looking after accounts receivable and payable. We can handle submitting client invoices, reconciling claims, managing vendor accounts, and more.

HR & Payroll

For many ABA providers, employing local HR and payroll services is a significant expense that erodes overall profitability. Pharmbills can provide outsourced HR and payroll services at a fraction of the cost of local providers, often with increased efficiency. This allows you to secure and maintain the talent you need to grow your ABA therapy clinic.

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Key Components of ABA Therapy Billing

Eligibility & Benefits Verification

The ABA billing process starts when a parent first contacts an ABA provider. Before the appointment, staff must check the patient’s insurance coverage, including reimbursement eligibility for an initial assessment. After the assessment, the insurer must be provided a detailed treatment plan so they can advise on coverage for the proposed course of action.

Claims Submission & Processing

Information that must be collected and included in ABA therapy claims includes patient demographics, current procedural terminology (CPT codes), and modifiers. In addition, payers may have additional specific requirements for each session. Finally, some payers have different reimbursement rules for board certified behavioral analysts (BCBAs) vs. other providers.

Compliance & Regulatory Support

As a relatively new type of care, the billing guidelines and regulations for applied behavioral analysis are constantly evolving. To maximize revenue, providers must stay aware of changes and adjust billing practices accordingly. Data collection and record keeping must also always be maintained, to be prepared for queries or audits by insurers or licensing boards.

Revenue Cycle Management

The revenue cycle for ABA therapy billing includes intake and prior approval, claims generation and submission, collection of payment from the client, claims follow-up, then collecting any further payments outstanding. To remain financially viable and optimize revenue, ABA therapy providers must effectively manage each step of the revenue cycle.

ABA Billing Expertise

Our team specializes in the unique challenges of ABA billing, including managing diverse payer requirements and complex authorizations.

Customized Solutions

We tailor our services to your clinic’s specific needs, whether you are a small practice or a multi-clinic organization.

Affordable & Efficient

Through the intelligent use of business process outsourcing, we can assemble a highly skilled team at a fraction of the cost of local talent.

Comprehensive Support

From front-end processes to denial management, we provide end-to-end revenue cycle management for your ABA practice.

Continuous Education

Our team stays updated on the latest ABA billing challenges, ensuring your clinic always meets current standards.

Proven Results

Our diverse medical and behavioral health clients have seen significant improvements in revenue since partnering with us.

Increased Revenue & Cashflow

By spending less time on claiming and billing, your team can focus more on revenue-generating activities.

Reduced Administrative Burden

When ABA therapists spend less time on administration, they have more capacity for delivering therapy.

Enhanced Accuracy & Compliance

Feel comfortable knowing that all of your data collection and documentation is complete and compliant.

Hospitals

Behavioral Health Clinics

Solo Providers

Multi Speciality Groups

Nursing Homes

Primary Care

Homecare Services

Healthcare Revenue Cycle Management Outcomes Achieved By Our Partners

Number of clean
Claims

Collection rate:
Medicare

Collection rate:
HMO payers

Collection rate:
Medicaid

Ave. department
scaling over the year

ABA Billing Services:
How We Work

With our 5-step success formula and the support of your personal Client Service Manager, your ABA therapy practice will be transformed in no time.

Initial Consultation & Enrollment

We meet with you to fully understand your business and explore your challenges and goals

Build a Winning Team

Work with us to assemble a customized team of experts to take your business to the next level

Change Implementation

Our rapid process means you change can start very quickly to begin transforming your business

Ongoing Support & Training

We will regularly communicate, upskill staff, and support you in achieving your business goals

Regular Reporting & Transparency

All changes and existing processes will be regularly monitored and reported on for full visibility

You're In Good Company

We’ve helped a diverse range of medical and behavioral health organizations save time on billing, reduce administrative burden, and improve revenue & cash flow.

Who We Work With

Partner Testimonials

S.Kravetz

Chief Operations Officer

We had a problem sourcing and retaining professional, skilled remote talent. Then we started working with Pharmbills and were extremely pleased that they delivered what they promised: smart, motivated people. As a result of having dedicated Pharmbills teams that mesh well with our culture, we’ve been able to markedly improve our collection rates. In just a couple of years, we’ve added a significant number of new team members. When we need to grow, Pharmbills gets the job done quickly and successfully

T.Dershowitz

Senior Controller

It’s always great when you can partner with a service provider who shares your values for top quality work and excellent customer service. In the 2 years we’ve been working with Pharmbills, we’ve expanded our remote workforce by about 6 times what it was when we started. Having such excellent customer service support makes it seamless and incredibly valuable when we need to handle changes and general development. It’s almost like our Pharmbills team works in our building! When we need to grow, they are always ready and we never miss a beat.

Viktoriia Hrechka

Revenue Cycle Manager

One of our biggest challenges was being able to scale rapidly and train new accounts receivables offsite workers to support rapid growth. Pharmbills has done a terrific job solving these issues and are great people to work with.

Elina Omelianenko

Senior Accounts Receivable Supervisor

After a month of training on insurance, Pharmbills now excellently handles the assigned tasks without the need for supervision. They select knowledgeable staff to be onboarded, making the process easier for the client. Their hard work and exceptional skills make them reliable partners.

Contact Information

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Other Pharmbills Services
You Can Benefit From

Outsourced Back Office Tasks

From invoicing to coding and issuing payments, we can handle all back-office tasks to streamline your daily business operations.

Client &
Vendor Communication

We step in as the primary billing contact for all clients and vendors. This frees up your team to focus on the tasks that contribute to your strategic goals.

Analysis & Reporting

You can only change processes that you have complete and accurate data about. Our data analysis & reporting services can be used for many different business metrics.

Accounts Management

Books out of balance? No problem. We can track, reconcile, and manage accounts and records of any type. Use our accounts management services for one-off or ongoing tasks.