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Updated on:
June 28, 2024
June 21, 2022

Role of technology in enhancing behavioral health billing services

Gett Johnson has 30+ years of experience in Healthcare I.T. and RCM Professional. His skillset includes being an expert in Healthcare I.T. software and hardware solutions. He is helping health systems, hospitals, ASCs, medical offices, and healthcare organizations become financially healthy by optimizing complete RCM processes.

ABA Providers Recover Dues From Patients To Efficient Your Account Receivables

Behavioral health billing is uniquely challenging. Mental health diagnosis codes make identifying mental conditions harder than physical ailments. So, insurers frequently deny claims in this sector due to insufficient eligibility verification.

Technology can help fix miscommunications between behavioral health payers and providers. By creating a seamless web of interconnected data, systems consistently transmit accurate information.

Here’s how machine-enabled billing services are boosting the behavioral health sector

Automatic Check-ins

Patients must consistently enter accurate information to streamline the billing process. To achieve this goal, use automatic check-ins. These systems will walk patients through a questionnaire, ensuring that they enter every field before continuing. Before transferring the information, the program will allow users to review everything they’ve entered. 

Get the most out of this setup by requiring patients to arrive at appointments 15 minutes ahead of time. For patients who sign up online, have customer service repeat some questions to establish accuracy. 

Note Taking Technology

When practicing behavioral health, taking notes is critical. These observations are integral to forming a long-term patient improvement plan. Also, these recordings leave a verifiable diagnostic trail that supports claims. Note-taking technology embeds these observations into an easily reviewable program. 

Eligibility Verification

Failure to establish eligibility is a key reason payers reject behavioral claims. Mental health diagnoses hinge on a physician’s judgment. As such, payers require credentialed pre-verification with accompanying documentation.

Some states have mandated that insurers provide coverage under certain conditions. These nuances, paired with insurers’ shifting standards, confuse many staff members. Thankfully, automatic programs can sort through a patient’s history and quickly determine eligibility. 

Artificial Intelligence Coding

Modern artificial intelligence is sophisticated enough to sort through the thousands of codes in the ICD-10-CM coding system. Such programs excel at matching simple conditions and services with the appropriate number. Unfortunately, complicated scenarios still befuddle these AI. So, most practices assign experienced coders to review the software’s work. 

Charge Entry

Charge entry is submitting figures to payers for them to reimburse. This step is critical, yet staff frequently mishandle it. A study of practices between 2016 and 2020 revealed how prevalent charge entry errors were. Researchers found that 17.2% of denied claims were rejected due to missing or invalid data

AI systems can alleviate these mistakes by seamlessly copying patient data from registration portals. From here, they can take information from physician notes and patient charts to form an accurate, formal claim. 

Incorporating technology is critical for behavioral health practices that want to improve RCM flow and maximum profitability.  The easiest way to get this improvement is by hiring a professional biller. Plutus Health has built its service around pairing top-tier staff with top-tier technology. This combination has consistently improved practices’ incomes. Start your journey towards maximized reimbursements by contacting us today. 

Key Takeaways

1. Automatic check-ins provide consistent prompts that help confirm accurate information. 

2. Note-taking technology benefits claims by establishing a diagnostic trail.

3. Systems can quickly determine patient eligibility. 

4. Coding AI excels at matching conditions and services with the appropriate code. 

5. Software can create accurate claims based on limited information.

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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.

Gett Johnson

Gett Johnson has 30+ years of experience in Healthcare I.T. and RCM Professional. His skillset includes being an expert in Healthcare I.T. software and hardware solutions. He is helping health systems, hospitals, ASCs, medical offices, and healthcare organizations become financially healthy by optimizing complete RCM processes.

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?

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Why should ASCs invest in RCM automation in 2026?