Why we rebranded the company

Mandated ABA treatment

If you know a behavior analyst or two, you will agree they are a committed, steadfast, and benevolent group of individuals. The Autism Community, including caregivers, researchers, professionals from many backgrounds, lobbyists, advocates, and behavior analysts, have banded together to meet the needs of this underserved population.

As more research was released that rendered ABA an empirically supported treatment proven to alleviate symptoms associated with autism spectrum disorder, it was not surprising to see the Autism Community call to action changes to policies governing the approved treatments for ASD. Let us review the claims process in more detail and recommendations from the content experts on managed billing.

Claim Defined


Claims Cycle Review

1. Determine eligibility and demographic information to ensure the service is covered with the client’s health plan. Next, file the claim with the payer. The claim is completed and either sent to the payer directly or sent to the clearinghouse. The clearinghouse will review a claim for accuracy, determining the next steps.
2. If the claim is free from errors, it can be sent directly to the payer. It is rejected, and there will be no explanation of benefits since the clearinghouse is the “middle person” vs. payer. Claims rejected at this stage can be considered an opportunity since they can be rectified before submission to the payer.
3. The payer will review the claim, accept it, and process it in this phase. A claim denied at this stage is associated with the payer and directly affects the reimbursement of the service provided.
4. Settlement or denial information is issued to the provider, along with payment (if applicable). An explanation of benefits (EOB) is given to the client.
5. Any remaining balance would be the responsibility of the client. Client’s typically like paying through online means, so having software to support those transactions is beneficial to collect the remaining balances owed.

Caregivers of children with developmental or intellectual disabilities may be riddled with a mixture of emotions in the upcoming weeks ranging from excitement to anxiety. Planning ahead and organizing new or modified routines is an important step to helping your child feel comfortable and safe when returning to school. There are many procedures to choose from that may help you and your child have calm and stress-free morning routines. Starting the day with structured routine and ensuring your child has plenty of time to complete the routine without feeling rushed will help set a positive tone for the rest of the day. These strategies are not only intended to be meaningful for the child, but parents as well. 

Research suggests caregiver’s of children with disabilities are at a greater risk for experiencing long durations of chronic stress. Hume, K., et al. (2020) released a publication with The UNC Frank Porter Graham Child Development Institute  discussing seven strategies for supporting individuals with autism through uncertain times.

The article highlights the need for caregivers to identify and prioritize their self-care routines during these unprecedented times. When parents fail to practice self-kindness and do not provide themselves the opportunity to recharge, then it is extremely challenging to be the best caregiver and show kindness in return (Hume, K., et al., 2020). Some simple but effective environmental and antecedent interventions to consider include: 

• Visual supports such as breakfast menus and morning schedules
• Provide choices whenever possible including what to wear, eat, sit or color of an item
• Environmental modifications such as setting out 5 sets of clothes or pre-made lunches for the week
• Priming of morning expectations and routines before bed
• Acknowledge and validate your child’s fears and emotions through collaborative problem-solving
• Set reasonable expectations and celebrate even the smallest step toward success

Another benefit of identifying routines in advance is it allows time to test the strategies or routines in advance and make changes to anything that isn’t working. It may also increase compliance with new routines when your child is provided opportunities to practice and provide input prior to the first day of school.

Whether your child is in a home, school, telehealth, or center-based setting (or a combination), parent participation in ABA therapy and training is crucial. When parents are actively involved, the young one is more likely to succeed. In addition, through parent training, the child will easily generalize their skills – carrying the skills they learn in the treatment center to their school, home, and community.

Parent training sessions primarily focus on sufficient knowledge of relevant concepts and approaches to optimize the young one’s treatment success and improve their quality of life. In addition, the sessions are tailored to work with each child on crucial elements like self-help skills, communication, and social skills.

ABA parent portals are designed to simplify parent involvement in the overall treatment to ensure the child gets the best results. 

This book is where it all started. Skinner is considered the founder of behaviorism, and this work outlines the fundamentals of the field and details the science of how certain behaviors can be modified. It will also help you understand how to reinforce healthy patterns with your clients. It’s important to note that, although this book is a gem in the field, ABA therapy has evolved to suit the times we are in, so it’s best to take the fundamentals into account while keeping in mind that there will be exceptions to the rules in some cases: It’s important to adapt your practice to the 21st century so that everyone feels as comfortable as possible while also integrating values from the traditions of ABA that are pertinent to your practice today. That being said, this is a great historic read from the behaviorism canon.

ABA is built on the backbones of scientific literature and methodologies. So, it shouldn’t be surprising that parents are often heavily invested in the rigor of ABA practices. Having the correct certifications and hiring experienced ABA therapists is critical. You need to be able to showcase your practice’s capabilities to parents. They are trusting you with their child–your organization needs to make them feel comfortable with their choice.

Obviously, this part can get tricky. How do you show parents that you’re an experienced and scientifically bound practice without shoving 50-page research papers in their faces? We recommend the following:

• Prominently display degrees and certifications on the wall.
• Showcase certifications, experience, and capabilities in marketing and promotional materials.
• Have one-on-one conversations with parents and discuss why ABA works and the science to back up your programs.
• Creating robust blogs that subtly showcase the science of why ABA works

During the selection process, parents will likely ask questions about your practices. Answer those questions as simply and concretely as possible. Remember, many parents come armed with Google-driven questions, and many have done independent research. It’s important to discuss your ABA strategies, inform parents of their benefits, and dispel any myths or misconceptions they may have stumbled across during their late-night Google journeys.

Science and rigor are at the heart of ABA. Helping parents understand (in simple language) the data behind your decisions will make them feel more comfortable. Be prepared to answer any and all questions thrown your way using up-to-date research.

There are different types of ABA therapy sessions and practices; all face specific scheduling needs and challenges.

In-home Appointments

ABA providers who have staff traveling in and out of client homes face unique challenges when scheduling. For many providers, some of these challenges include:

• Matching the best clinician to the client
• Tracking payroll hours for overtime
• Allowing time for mandated breaks & lunches for hourly employees on the go
• Forgetting to calculate drive times & mileage
• Clients not being home when therapists arrive for a session
• Prior authorizations validated for services scheduled
• Staff members radius of travel between appointments
• Signature collection

Treatment Centers / Offices

Some client sessions are scheduled at an ABA practice’s center(s). With treatment centers and offices, scheduling is challenging because there are multiple staff and multiple clients all in the building at the same time. Because of this, the calendar must be scheduled perfectly to make sure everything runs like a well-oiled machine. Common scheduling challenges and needs for treatment centers/offices include:

• Overlapping schedules (client sessions with training, supervision time, staff meetings, etc.)
• Prior authorization management 
• Types of services rendered
• Unit tracking within authorizations
• Consistency of the therapist’s schedule
• Staff, supervision, and training meetings
• Matching the correct therapist to the client (appropriate licensure, etc.) 

Here’s a scenario that might sound familiar to ABA therapists and admin staff.

Let’s say an RBT were to call in sick one morning, with a cold. This puts your organization in a pinch without much time to figure out the next steps. The families your RBT would have met with that day need to be paired with other RBTs to fill the hole. It is not as simple as just pairing them with whoever is free, there are dozens of considerations that need to be taken into account when matching a family with a provider.

For example, let’s say one of the families that the provider was supposed to meet with has a dog. The RBT working with that family would need to be ok with dogs. In a more complicated light, let’s say that the family has a custodial parent whose primary language is not English, the RBT would need to be able to manage that dynamic. Taking it a step farther, what if the child needs to be lifted from time to time or that they are prone to violence and poor verbal communication. The RBT that is paired to work with them will need to be able to lift their weight and effectively manage the child’s range of emotions.

It is considerations like these that make matching providers to families so challenging. With a scheduling tool, providers can customize a list of considerations to help administrators match more easily. After checking off each factor that needs to be considered, a list of providers that work for that family will automatically populate. This tool not only takes into account the needs of the family but also their insurance needs, the provider’s abilities/needs, the geographical location of the visit, and who is available on the schedule. A quality scheduling tool streamlines and simplifies the entire process.

There was a time when behavior analysis treatment did not exist. Our culture had a hundred different reasons and explanations for why people behaved in specific ways or why some people were outside of what society considered “normal.” The study of behavior emerged within psychology and neurobiology as we developed observational and technological scientific methodologies.

Behavioral analysis is the study of behavior, how it works, and how it is influenced. In the early years of psychology, most professionals did not consider or analyze behavior or its relationship to the psyche. Back then, psychology centered on internal thoughts and consciousness, or parts of the mind that were considered unobservable. (They didn’t have neurologists and MRI machines in those days!) This was the Freudian model of understanding consciousness.

In 1913 American psychologist John Watson stepped away from Freud’s model and developed another school of thought in the emerging field of psychology: behaviorism. In simple terms, the new field could be described as the science of observable behavior.

Behaviorism rejected the unobservable mind, as Watson thought this research method was subjective and unscientific. Watson’s theories became influential in their application to the study of child development. He asserted that a child’s observable environment is the most critical factor for determining their behaviors.

As time progressed, Watson’s theories of development were embraced by influential behaviorists in history, including Jacob Robert Kantor, Ivan Pavlov, and B.F. Skinner. Skinner’s theory of Operant Conditioning, which believes that associations between behavior and consequence can lead to behavioral changes, is probably the most famous theory to emerge within the field. Every Psychology 101 course in college touches upon Operant Conditioning and Skinner’s work.

This form of punishment is tremendously effective because the individual who faces consequences will associate the absence of the item they love with their poor behavior. For this reason, they are likely to change their ways. This won’t usually happen all at once, but, as they begin to realize that the consequences are consistent, they will probably adjust their behavior.  

Negative punishments are essential in many areas of society, including the classroom, law enforcement, and businesses. They can be an excellent way to maintain firm boundaries when you are running a company, teaching a class, or driving down the road: Consequences, when implemented fairly across the board, make the world a safer place for everyone involved.  

Loom is a free screen and video recording software that can help snap a video of your face right on your screen along with your voice to help you create videos that you can share with your clients and their parents. For example, you might want to send a video explaining how you will still meet with clients over the internet instead of in-person. Loom makes it easy to explain how telehealth works and the kind of tools your clients need on their end if they want to participate. Loom plays well with Mac, iOS, Windows, and Chromebook so wherever you work, with whatever system you prefer, you can use Loom.

You can use Loom for training videos about the remote telehealth appointments or other teachable moments that help clients and parents feel more secure when using telehealth.

Small Business Administration Relief Options

The Small Business Administration is also administering several other COVID-19 relief options that your ABA therapy practice could qualify for. The Economic Injury Disaster Loans can provide up to $2 million in loans to small businesses. When you apply for the EIDL, you may also qualify for the EIDL Emergency Advance which can provide up to $10,000 in grant funding for small businesses that have experienced a temporary loss of revenue due to the pandemic. SBA Bridge Express Loans can give businesses who already have a relationship with an SBA lender access up to $25,000 quickly. The SBA Debt Relief program is also providing up to 6 months of debt relief for SBA loans. Compare SBA COVID-19 Disaster Loans in this chart.