Choosing the Right ABA Billing Partner: 10 Questions to Ask Before You Sign
For ABA providers, billing is more than just submitting claims—it’s about navigating insurance rules, managing prior authorizations, and maintaining accurate documentation. Many practices turn to an ABA billing partner to reduce administrative stress and cut down denials. But choosing the wrong partner can lead to revenue delays, compliance problems, and frustrated families.
This guide highlights the 10 most important questions you should ask before signing with an ABA billing partner, so you can make a confident, informed choice.
Table of Contents
Why Your ABA Billing Partner Important?
ABA billing is not like general healthcare billing. It requires specialized knowledge in:
Securing and renewing prior authorizations for high therapy hours.
Managing detailed treatment documentation that payers require.
Correctly applying ABA-specific CPT codes and modifiers.
Monitoring compliance to avoid costly recoupments.
Studies show that practices working with ABA-focused billing partners see 20–30% fewer denials and faster reimbursements compared to in-house billing teams. The right partner doesn’t just file claims—they protect your practice’s revenue cycle.
10 Questions to Ask Before You Sign with an ABA Billing Partner
1. Do you specialize in ABA therapy billing?
ABA billing has unique codes, modifiers, and rules. Choose a partner with proven experience supporting ABA providers.
2. How do you handle prior authorizations?
Since prior authorization is a major bottleneck, ask if the partner manages submissions, renewals, and tracking expirations.
3. What’s your denial management process?
Every billing partner should investigate denials, fix errors, and resubmit claims quickly.
4. How do you ensure compliance with documentation standards?
Proper documentation is key for payer approval. Ask if they audit records or provide compliance checks.
5. What reporting and analytics do you provide?
You’ll need full transparency into collections, outstanding claims, and denial rates.
6. How familiar are you with ABA billing codes?
Codes like 97153, 97155, and 97156 are often misused by general billers. Correct coding prevents denials.
7. Do you offer credentialing support?
Credentialing is essential for staying in-network. Strong billing partners help providers maintain payer relationships.
8. What technology or software do you use?
Check if their tools track authorizations, integrate with your EHR, and provide automated alerts.
9. How do you communicate with providers and families?
Billing often raises questions from families. Clarify whether they manage these inquiries directly.
10. What are your fees and contract terms?
Ask about pricing models (percentage vs. flat fees) and avoid contracts with hidden costs.
Red Flags in Choosing an ABA Billing Partner
No clear denial management plan.
Limited or vague ABA-specific experience.
No transparent reporting access.
Long-term contracts with no exit option.
These are warning signs that could cost your practice in the long run.
The Bottom Line on Outsourcing ABA Billing
The right ABA billing partner should feel like an extension of your practice. They should reduce administrative headaches, help you get paid on time, and ensure compliance with payer rules.
At MBW RCM, our ABA therapy billing services are built around the unique needs of ABA providers. From coding and prior authorizations to denial management, we handle the details so you can focus on care. See how we’ve helped practices streamline operations in our ABA billing case study.
For families learning about ABA, the CDC’s Autism Spectrum Disorder resources provide valuable background on therapy and insurance. And for providers, the American Psychiatric Association’s Mental Health Parity page explains how parity laws protect coverage for behavioral health.
FAQs: Outsourcing ABA Billing
Request for Information
Looking for an ABA billing partner who understands the complexities of autism therapy? At MBW RCM, we specialize in ABA billing, prior authorization management, and denial reduction.
