ABA billing can be overwhelming, especially for new providers or office teams unfamiliar with insurance procedures. Whether you’re just starting or looking to improve your workflow, understanding the correct ABA billing steps is key to getting reimbursed on time and keeping your practice financially healthy.
At Taylor Prime Solutions, we’ve broken down the steps to ABA billing into a clear and simple guide you can follow.
✅ ABA Billing Step 1: Verify Insurance and Eligibility
Before any services begin, confirm the client’s insurance details:
-
Check active coverage and behavioral health benefits
-
Confirm plan-specific requirements (like deductibles or copays)
-
Note any limits on ABA sessions or hours
💡 Pro Tip: Save this information securely and update it quarterly to avoid billing rejections.
✅ Step 2: Obtain Prior Authorization
Most payers require pre-approval before treatment begins. Authorization includes:
-
Submitting an initial assessment or treatment plan
-
Documenting medical necessity
-
Tracking expiration and renewal dates
💡 Missed authorizations are one of the top reasons for denials in ABA billing.
✅ Step 3: Track and Document Sessions Properly
Accurate documentation is critical. Always include:
-
Start/stop times of each session
-
Type of service provided (supervision, parent training, direct therapy)
-
Staff credentials and setting (in-home, in-school, etc.)
Use correct CPT codes like 97151, 97153, 97155, and include applicable modifiers (e.g., HM, HN, or GO for supervision levels).
✅ Step 4: Submit Claims Accurately
Once services are rendered and documented, submit claims through your billing software or clearinghouse.
Make sure to:
-
Match codes to payer-specific guidelines
-
Double-check authorization numbers and patient info
-
Use a CMS-1500 form if billing manually
✅ Step 5: Monitor Payments and Manage Denials
Stay on top of Explanation of Benefits (EOBs) and remittance advice to:
-
Track what was paid vs. denied
-
Identify patterns in rejections (missing modifiers, incorrect codes, etc.)
-
Appeal denials promptly with corrected claims or additional documentation
✅ Step 6: Reconcile Payments and Bill the Patient
Once payments are posted:
-
Record all transactions
-
Send statements to patients for any remaining balances
-
Set up payment plans if needed
💡 Transparency and consistency here build trust with families and strengthen your practice’s reputation.
📚 ABA Billing Steps Related Readings
💼 Let Us Handle Your ABA Billing
Following all these ABA billing steps is time-consuming, especially while managing sessions, staff, and treatment plans. That’s where we step in. We’re not just a billing company — we’re your back-office billing team.
With decades of experience in ABA billing services, we help behavioral health providers:
-
Get reimbursed faster
-
Reduce claim denials
-
Stay compliant with payer policies
-
Focus more on client outcomes, not billing headaches
📞 Call us today: 844-TAYLOR-9 (844-829-5679)
🌐 Visit us on the web
📧 Message us here
