Printable scorecard
12 questions to ask an ABA billing company.
Compare vendors, including us, on ownership, visibility, follow-through, proof, security and exit. Not just the percentage. Score each answer 0 (no answer), 1 (vague) or 2 (specific and in writing).
The 12 questions
- 1Ownership
Who exactly will work my claims?
Why it matters: Many vendors sell with one person and bill with another. You need a name you can email when something is stuck.
A good answer sounds like: “This named person works your account, and this is who covers when they are out.”
Notes - 2Ownership
Do you work only with ABA?
Why it matters: ABA has its own codes, units, supervision rules and authorization limits. A general biller learns them on your claims.
A good answer sounds like: “Yes, or ABA is most of what we do.” Plus specifics: 97153 units, modifiers, unit caps, recert timing.
Notes - 3Visibility
What will I see each week, and can I see a sample?
Why it matters: If you cannot see what moved and what is stuck, you find out about problems months later.
A good answer sounds like: “Here is a sample weekly report.” It shows what moved, what is stuck with a reason and owner, and what needs your decision.
Notes - 4Follow-through
How do you handle authorizations before sessions?
Why it matters: A session without a valid authorization or enough units is hard to get paid, and you only learn after the work is done.
A good answer sounds like: A set lead time for checking eligibility and authorizations before sessions, and who tells the front desk when something is short.
Notes - 5Follow-through
How do you work denials, and who decides on appeals?
Why it matters: Denials left in a queue age out. Appeals cost time, so you should know who decides and how.
A good answer sounds like: A target time to review each denial, a log with reason and next step, and you deciding on appeals or write-offs above an agreed amount.
Notes - 6Follow-through
How do you handle credentialing, and who tracks effective dates?
Why it matters: Billing before a provider’s effective date with a payer can mean claims that are never paid.
A good answer sounds like: “We track each provider with each payer and only treat them as billable once the effective date is in writing.”
Notes - 7Proof
What do you need from my team?
Why it matters: Every billing setup needs something from the clinic. Vague answers here become surprises later.
A good answer sounds like: A short, specific list: signed notes by a set time, schedule access, a named clinic contact, documents for payers.
Notes - 8Security
Do you sign a BAA before any PHI moves?
Why it matters: HIPAA expects a Business Associate Agreement with a billing company. It should be signed before they see patient data.
A good answer sounds like: “Yes. The BAA is signed first, and here is how access, MFA and offboarding work.”
Notes - 9Proof
Will you work in my current EHR?
Why it matters: Switching your EHR for a biller is a big, risky change. It should be your choice, not their requirement.
A good answer sounds like: “Yes, we work in your system,” or a clear reason why not and what that would cost you.
Notes - 10Proof
What does pricing include and exclude?
Why it matters: Percentage prices hide differences: minimums, setup fees, credentialing fees, charges for old AR or appeals.
A good answer sounds like: Every fee in writing: percentage, what it is a percentage of, minimums, one-time fees and what costs extra.
Notes - 11Exit
What happens to my data and open AR if I leave?
Why it matters: Leaving is when you lose leverage. The terms should be clear before you sign, not after.
A good answer sounds like: Notice period, how your data and reports come back to you, and who works the claims still open at the end.
Notes - 12Proof
Can you show me how you’d handle Texas Medicaid and my managed care plans?
Why it matters: Texas Medicaid (TMHP) and each managed care plan have their own enrollment and authorization steps. Ask for your actual payers.
A good answer sounds like: Specifics for your payer list: TMHP enrollment, each plan’s credentialing and prior authorization, and where they would check current rules.
Notes
How Billing4ABA answers
Our public answers, so you can score us the same way you score anyone else.
- Who works my claims?
- Ahsan Khan, the founder, leads the work. You get a named person, not a ticket queue.
- ABA only?
- Yes. Billing built only for ABA.
- What will I see?
- A daily report, a 7-day eligibility and authorization report, a weekly summary, a bi-weekly credentialing report and a month-to-date report. See the samples.
- BAA?
- Signed before any PHI moves. Security and HIPAA details.
- Pricing?
- Full billing is 5% of collections with a $500 monthly minimum. Onboarding is $250, one time. Credentialing is billed only after the payer approves.
- Contract length?
- No long-term contract under our current agreement.
- Results?
- We do not promise collection amounts or denial rates. We promise to show you the work, every week.
- How do I leave?
- The terms are in the agreement. Ask us to walk you through data return before you sign.
In-house or outsourced: your numbers
Type in your own figures. Nothing is filled in for you and nothing leaves this page. The result is your estimate, not a quote and not a prediction of what you will collect.
Add your figures
Needs hourly rate and hours per week.
Add collections
Plus $250 onboarding, one time. Credentialing billed after approval.
This is your own estimate from your own inputs. It leaves out things only you can weigh: cover for sick days and turnover, owner time spent supervising billing, and the reporting you get.
ask us all twelve.
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