On-time posting of payments for ABA providers
ABA Providers, who’s training and time are focused on treating clients, may not be adept in working with Insurances or stay in sync with the evolving methods and technologies of payment posting in medical billing, and can find the whole process utterly or partially confusing and even miss out on key areas and make errors. So, here is a detailed guideline about the role of importance of on-time posting of payment in Revenue Cycle Management (RCM) and a step by step process of payment posting for ABA Providers that help them as well as the clients’ family to function holistically.
Understanding Payment Posting
Payment Posting is an elementary step in Medical Billing. This is the process of logging or posting the payments and related information in either manual paper EOBs and receipts, or as automated ERA entries in the billing software or practice management systems. The entries should include:
● Payments received from insurance companies and other sources based on Electronic Remittance Advice (ERA), which is an explanation of the claim’s payment provided by the insurance company.
● Insurance coverage and other payment details based on the Explanation of Benefits (EOB),which is an account of things explained to the patient by the payer.
● General information of clients, including patient demographics, account records, payment balances of cost of care etc.
● Unpaid insurance claims, it's current status and other details regarding the claims.
● Track denials- these are statements given by the Insurance Companies denying to honor the request by the provider or patient to pay and why they can't do so. For ABA providers, working with denials is a constant process. There can be soft and hard denials, with soft denials being re-filed, while the hard denials are final. With well-organized and categorized denials tracking, providers can reduce the volume of denials, and avoid the mistakes and errors that may be the common cause of denial.
Best Practices And Process Of Accurate Payment Posting in Medical Billing
The Process of Payment Posting requires the collection and uploading of the relevant data, into the software. Among the best practices of ABA payment posting, is to maintain a consistent timekeeping between billing and payroll. Whether you use any billing software, or simply maintain an Excel Sheet, it is recommended that you update the software or management system every day, or at least once a week, to avoid any unforeseen situation when you have to search for valuable information that is needed.
Some of the best practices of payment posting are:
● Keep a copy of all checks and payments made by both clients and insurance companies, in"daily batches" of files or folders. And store them at convenient and secure places, that is also easily accessible when needed.
● Coordinate EOBs with Electronic Fund Transfers (EFT) and keep them together, to have a complete account of payments.
● Avoid delays in depositing the checks, and do it as and how you get them, according to the daily batches. Thus, you can maintain subsequent information for taxes and insurance-related inquiries and audits.
● Have the patient's responsibilities, and payments allocated separately, and concisely while posting the payments
● Merge all checks with a single bank account and a single payment posting interface to make it consistent and transparent for the year-end tax audits to review your accounts.
● Include all miscellaneous documents, such as payment receipts for clients, monthly, weekly or ongoing payments, as well as co-pay amounts into segregated fields. In case you have any co-pay amounts, you can collect them upfront.
Outsourcing Medical Billing
Applied Behavior Analysis (ABA) is among the most scientific and documented approaches for Autism Spectrum Disorder. This is administered as a continual therapy. The individualized costs of care for a single patient, including ABA Therapy and additional medical treatments are above $3 Million in the US, that can increase up to $7 Million. Such an amount is largely beyond the capacities of parents and families to afford out-of-pocket, even as a monthly,annual or an ongoing bill.
Therefore, Health Insurances are practical solutions for the cause. And for the reimbursement coverage, ABA providers must administer timely Payment Posting, which is crucial for Medical Billing.
With the emergence of highly skilled Medical Billing companies and technology, ABA Providers can breathe a sigh of relief, for being able to outsource the payment posting and denial tracking that successfully helps Providers reduce claim denials and optimize revenue.
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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.