Accurate Patient Statements for Better Customer Satisfaction
A 2018 report showed that U.S. medical practices leave approximately 125 billion dollars on the table annually. The report attributed this loss to poor billing habits. Studies like these impress the importance of accurate financial transactions.
Patient statements are the backbone of medical billing. Here are the best ways you can produce accurate patient statements.
Switch to Digital Invoices
Sending physical bills is more time-consuming and expensive than digital. Digital billing users can copy information from stored data seamlessly into a statement. This precision helps keep invoicing flawless.
Some financial systems will automatically alert a sender when a receiver opens a bill. This notification circumvents the arduous task of determining if a physical copy reached the target.
Most patients have access to and prefer online options. 72% of responders said they wanted e-statements for health plan premium bills in a recent survey. By shifting to digital invoicing, practices will boost efficiency and increase patient satisfaction.
Consistent Detail Verification
Ideally, the statement sending process should not include extensive information checks. If your team prioritizes critical details, your staff should trust their documentation’s accuracy. Here are a few essential items your team should consistently monitor.
● Contact Details: Practice standards must support patient communication. Ensure that the patient agrees to receive messages and that their contact details are accurate.
● Insurance Eligibility: Even after insurers provide practices with an explanation of benefits (EOB), billers fail to catch problems. Confirm that the coverage insurers have given is adequate given the circumstances. After establishing sufficient coverage, accurately charge based on the insurer’s report.
● Early Collection: Ask for co-pays up-front. This will help avoid future instances where billers have to track down this information during a later stage. Also, a patient is less likely to pay for a service the longer you fail to collect.
Avoid Confusing Statement Information
Patients frequently misunderstand their medical bills. A survey reports that 70% of consumers claim their medical bills confuse them. This confusion can lead to delays, time-consuming customer service, and disgruntled patients.
Avoid including balance aging. Balance aging is useful for billers in categorizing late payments. However, consumers may misinterpret this information as optional due date extensions. Also, when possible, use the full name of a procedure instead of abbreviating it. Shortening titles can befuddle non-medical experts.
Contact Agencies Over Unclear Insurance Denials
For online claim submissions, insurers may not provide an EOB. Instead, they will return the claim number and denial codes. Teams often fail to catch fixable errors in this stage and will send an overpriced invoice.
Train your staff on standard denial codes and how to research others. Note recurring codes to help identify and fix these errors. If your team is struggling to understand the problem, contact the insurer for more details.
Outsource to a Professional Billing Service
High-quality revenue cycle management is easy in concept but complex in execution. Many practices pride themselves on their involvement in coding and billing. Often, financial gains would rise if a professional billing and coding service handled invoicing. However, understand your team’s limitations.
At Plutus Health, we prioritize statement accuracy while maintaining quick return time standards. Our expert team takes meticulous steps to maximize a service’s reimbursement. Learn how we will boost your practice’s revenue cycle performance by contacting a representative today.
Key Takeaways
1. Digitize your invoicing to increase efficiency and satisfy consumers.
2. Regularly verify details so billers can send statements quickly and accurately.
3. Avoid including information in a bill that will potentially confuse patients.
4. Train your staff to identify denial codes and contact insurers when confused.
5. Opt to hire a professional billing and coding service when invoicing pushes your limits.
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FAQs


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.


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.


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.


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.


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%.


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.


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.


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.
FAQs


ABA therapy billing is the process of submitting claims to insurance or Medicaid for Applied Behavior Analysis services provided to individuals with autism or developmental disorders. It includes using correct CPT codes, proper documentation, and adherence to payer-specific policies.


Common CPT codes for ABA therapy in 2025 include:
- 97151 – Assessment and treatment planning
- 97153 – Direct therapy with the patient
- 97155 – Supervision and modification of behavior plan
- 97156 – Family adaptive training
- Always check with payers for any annual changes.


To bill Medicaid for ABA services, providers must ensure credentialing is complete, services are pre-authorized, and claims use the correct codes and modifiers. Medicaid requirements vary by state, so always follow state-specific billing rules.


Common ABA billing mistakes include:
- Incorrect or missing CPT codesplan
- Lack of documentation or treatment
- Uncredentialed providers rendering services
- Submitting duplicate or late claims


Without proper credentialing, providers can’t get reimbursed. Insurance and Medicaid require that BCBAs, RBTs, and organizations are credentialed and contracted. Delays in credentialing often cause revenue losses and claim rejections.
FAQs


CMS proposes a 2.4% increase in Medicare ASC payment rates, contingent on meeting ASCQR quality reporting requirements. Plutus Health helps ASCs meet these compliance benchmarks by integrating quality reporting data into RCM workflows, ensuring eligibility for full payment updates.


The ASC Covered Procedures List will expand by 547 procedures, including cardiology, spine, and vascular surgeries. Plutus Health supports expansion into new service lines by customizing RCM processes for high-acuity procedures, minimizing claim denials during the transition.


Site-neutrality narrows the payment gap with hospital outpatient departments, enhancing ASCs' cost-efficiency appeal. Plutus Health helps leverage this advantage in payer negotiations by providing performance dashboards and cost-justification analytics to secure stronger reimbursement terms.


Complex procedures increase denial risk and slow cash flow. Plutus Health's automation-first RCM model delivers 95%+ clean claim rates, reduces A/R days, and safeguards margins, even as your case mix becomes more complex.