ABA insurance billing can be an overwhelming task even for the most organized practices as it needs careful attention to minute detailing. If your current system is causing many headaches, then it may be time to look for new time-saving solutions that can increase accuracy and success. Here are five tips to help you get started:
- Understand insurance coverage with your location and clients in mind.
On October 1, 2019, the District of Columbia and 50 states mandated insurance coverage for ABA therapy, but not all 50 states universally cover ABA therapy. So, to make sure you’re eligible to get paid for services rendered, confirm your patient’s health insurance eligibility and how it covers their ABA therapy.
- Make sure your practice is acknowledged by the insurance company.
You have to be credentialed by the insurance company to ensure smoother ABA insurance billing. Credentialing is important for your eligibility to accept payments from the insurance company. Be sure to meet the conditions and prerequisites of every insurance carrier, including credentialing for therapists. You should provide documentation supporting your application for approval, such as your CV, medical licenses, a list of hospitals where you have admission privileges, and others.
- Make sure you’re an in-network provider.
Patients covered by an HMO or PPO should get health insurance from the HMO’s staff or a preferred provider. Insurance plans reimburse an in-network provider at a higher rate compared to those outside the network. At times, insurance won’t even cover out-of-network services, so the patient will have to take care of all the expenses.
- Pay attention to claim denials.
Give special attention to claim denials. Avoid ignoring them when they occur. Appeal the decision immediately, but follow the insurance provider’s appeal procedures. That way, denied claims won’t cause further issues with your ABA insurance billing process.
- Establish a system for filing claims and getting paid.
This means implementing a practice management system that can cover ABA insurance billing to make claims submissions and payments hassle-free.
Outsource your ABA insurance billing
It’s often more cost effective to outsource insurance billing functions to a trusted provider of ABA revenue cycle management solutions. Plutus Health Inc. can tailor strategies based on the unique billing challenges of your practice. Get in touch today to find out how we can decrease your denial and rejection rates while improving your cash flow.