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Updated on:
August 22, 2023
October 16, 2022

5 Ways to Measure Your ASC Billing Process

Dr. J is a Physician, MBA graduate, AAPC Certified Coder (COC), and ASQ Certified Six Sigma Black Belt (ASQ CSSBB) with 20+ years of experience in the Healthcare Industry. His key expertise areas include coding in multiple specialties, end-to-end RCM, multiple market segments, product and process innovation for the healthcare business, lean six sigma management, and process design and improvement.

ABA Providers Recover Dues From Patients To Efficient Your Account Receivables

Modern data enable ASCs to make fine-tuned adjustments that build an efficient workforce. Yet, practices routinely fail to identify critical areas that need review. Far-sighted providers will spend significant time researching how to best gauge invoicing proficiency. 

Here are five ways to measure the effectiveness of your ASC billing process. 

Adopt Key Performance Indicators

Key performance indicators (KPIs) are measurable standards that an ASC should track over time. Failing to set and observe appropriate KPIs will obscure a practice’s performance.
Here are some of the most critical billing standards: 

●  Clean Claims Percentage: A high clean claims percentage indicates billing precision. Review industry data to determine what claim acceptance rate is acceptable for your practice. 

●  Annual Changes: Comparing quarters across years gives practices a broad overview of their financial performance. 

●  Long-Lasting A/R: Experts suggest keeping the percentage of A/R over 90 days below 15%. If your practice exceeds this threshold, your billers may have prioritization problems. 

●  Days Sales Outstanding (DOS): DOS is the average number of days spent in A/R. High DOS implies your team is behind on patient engagement. 

●  Days to Bill: Billing delays often translate to inflated DOS, time-sensitive denials, and write-offs. 

●  Days to Pay: Knowing which insurers take the longest to pay creates an invaluable chart. Slow payers may need contract adjustments or specialized invoicing procedures. 

●  Write-Off Percentage: Write-offs frequently occur because of failures to follow basic regulations. Excessive write-offs should make practices redesign their billing structure.  

Track Scheduling Failures

An efficient ASC should avoid gaps where facilities or workers are idle. Unfortunately, scheduling failures often leave staff unengaged, even during busy quarters. This lag can lead to billing teams having little work one week, then too much the next. 

Make notes each time scheduling failures slow workflow. Review this record at the end of the month. This process will reveal how much avoidable downtime your practice accrues monthly. 

Audit Payer Contract Knowledge

A lack of denials does not guarantee that billers are securing maximum returns from payers. Insurers will never press practices for the privilege of paying more. So, providers must audit billers to determine how well they understand contracts. 

Gauge staff’s contract familiarity by monitoring when they request additional details. Waiting until submission deadlines before seeking necessary documents indicates poor payer understanding. 

Review Provider Communication Breakdowns

Many errors occur because of communication breakdowns between providers and invoicing staff. Internal audits should review physician notes to ensure they supply billers with necessary, clear information. Digital records simplify communication standardization and note inspections. 

Hire a Professional Billing Service

Measuring in-house billing effectiveness requires significant time and energy. To eliminate this burden, professional invoicing companies deliver regular reports that detail their performance. These statements show claims, timelines, and amounts secured. So, providers have all the information necessary to determine whether billers satisfy their standards. 

Plutus Health maintains clinical records and provides regular reports outlining our work. This precision has consistently earned us high returns and numerous accounts. As a result, our certified ASC coders have solidified their skills, fortifying practices’ income. Connect with us, so we can walk you through our financing options. 


Key Takeaways

1. Regularly track key performance indicators. 

2. Mark scheduling failures as disruptions to your billing workflow. 

3. Audit insurance contract knowledge. 

4. Review communication between providers and invoicing staff. 

5. Professional billing services routinely report their performance. 

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Faq

What are the top workforce challenges facing ABA therapy providers in 2025?

ABA providers are grappling with high staff turnover (up to 65%), rising burnout, administrative overload, and stagnant reimbursement rates. These challenges directly impact care continuity, clinical outcomes, and operational performance.

How does operational inefficiency affect ABA organizations?

Operational inefficiency costs ABA teams up to 10 hours per staff member per week, contributing to burnout, denied claims, and longer accounts receivable (A/R) cycles. These inefficiencies ultimately result in reduced revenue and patient dissatisfaction.

Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?

Burnout leads to costly turnover, lower client retention, and decreased productivity. Recruiting and replacing a BCBA or RBT can cost up to $5,000 per hire, plus months of lost revenue and disruption to morale.

What are effective strategies for improving ABA staff retention?

High-performing ABA organizations invest in clear career pathways for BCBAs and RBTs, align compensation with market benchmarks, and foster peer-led mentorship, flexible schedules, and wellness programs.

How can ABA organizations reduce the administrative burden for clinicians?

Automation tools like Plutus Health's Zeus streamline eligibility verification, denial management, and billing, reducing manual workloads by 5–10 hours weekly per clinician and improving clean claim rates by 95%.

What's the ROI of outsourcing RCM in ABA therapy organizations?

Outsourcing revenue cycle management can improve collections, reduce denials by up to 30%, and free clinicians from billing-related admin tasks, resulting in better client care and financial outcomes.

What's a proven example of operational transformation in ABA?

One $200 million ABA network partnered with Plutus Health to automate eligibility and accounts receivable (A/R) processes. The result: $2M reduction in legacy A/R and a 97% Net Collection Rate.

How can ABA organizations prepare for value-based care models?

By improving operational efficiency, investing in technology, and ensuring workforce stability, ABA leaders can align outcomes with reimbursement. Plutus Health supports this transition with scalable RCM and automation strategies.

Dr. Jagadeesha. G. S

Dr. J is a Physician, MBA graduate, AAPC Certified Coder (COC), and ASQ Certified Six Sigma Black Belt (ASQ CSSBB) with 20+ years of experience in the Healthcare Industry. His key expertise areas include coding in multiple specialties, end-to-end RCM, multiple market segments, product and process innovation for the healthcare business, lean six sigma management, and process design and improvement.

FAQs

What are the top workforce challenges facing ABA therapy providers in 2025?
How does operational inefficiency affect ABA organizations?
Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?
What are effective strategies for improving ABA staff retention?
How can ABA organizations reduce the administrative burden for clinicians?
What's the ROI of outsourcing RCM in ABA therapy organizations?
What's a proven example of operational transformation in ABA?
How can ABA organizations prepare for value-based care models?

FAQs

What is ABA therapy billing?
What CPT codes are used for ABA therapy in 2025?
How do you bill Medicaid for ABA services?
What are common ABA billing errors to avoid?
How does credentialing affect ABA billing?

FAQs

How much will ASC Medicare payments increase in 2026?
What's changing in ASC procedure eligibility?
How do site-neutral payments affect ASCs?
Why should ASCs invest in RCM automation in 2026?