Services · ABA revenue cycle

The ABA revenue cycle, stage by stage.

Nine stages, three acts — and exactly where revenue tends to leak when no one is watching.

  • $15–40k
    lost per quarter to dead denials
  • 8–18%
    first-pass denial without scrubbing
  • 3–6 mo
    of revenue burned getting started
Walk the cycleBook a free billing review
Act I · Stages 1–3
Foundations
Get the bones right.
Act II · Stages 4–7
Operations
Run the weekly engine.
Act III · Stages 8–9
Scale
Grow without breaking.

KPIs are typical ranges for clinics we work with — your numbers depend on payer mix, region, and starting state.

IAct I · Stages 1–3

Foundations. Get the bones right.

Stage 01 / 09· Act I · Foundations
Dream

Decide you're really doing this — your own ABA practice.

Without us · the leak
3–6 months
of revenue you'll never get back
With us · the fix
1-week plan
from idea to a clear first-billable-client roadmap
1 call · 30 min · same week·Owner: Founder·Cadence: Once
Where revenue leaks

A thousand tabs open and no clear first move. Months pass before the first billable hour because nobody explained the order of → → .

What we run for you
  • Free 30-min call to map your starting point
  • Honest answer on what billing will actually cost you
  • A simple path from idea to first billable client
From you
  • Where you are today
  • Who you want to serve
  • Rough timeline + budget
From us
  • A map of every step ahead
  • Honest go / no-go answer
  • Order of operations
↓Once you commit, the legal bones go up next.
Stage 02 / 09· Act I · Foundations
Clinic Setup

Stand up the legal and identity bones of the clinic.

Without us · the leak
$2–5k / mo
every month credentialing is blocked on paperwork
With us · the fix
2–3 weeks
from docs in hand to a credentialing-ready clinic
2–3 weeks if docs are ready·Owner: Founder + Billing4ABA·Cadence: One-time
Where revenue leaks

Wrong type, missing W-9, half-finished — small errors that block every payer downstream for months.

What we run for you
  • Checklist for LLC / / Type 2
  • We set up and maintain your the right way
  • Document vault so nothing gets lost between payers
From you
  • Driver's license + W-9
  • Business name + address
  • Hours of availability
From us
  • LLC / EIN / NPI guidance
  • CAQH profile + attestations
  • Document vault setup
↓With the bones in place, payers can actually credential you.
Stage 03 / 09· Act I · Foundations
Payer Credentialing

Get in-network with the Medicaid and commercial payers you need.

Without us · the leak
$8–20k / mo
per uncredentialed payer for a 4-BCBA clinic
With us · the fix
38 days avg
to first payer approval, with a live status board
60–150 days per payer (we shave weeks off)·Owner: Billing4ABA·Cadence: Per payer · 60–150 days
Where revenue leaks

Months of silence. Lost applications. “We never received that.” Revenue locked behind paperwork while overhead keeps running.

What we run for you
  • File, track, and follow up payer by payer
  • Same-week responses to payer requests
  • Live status board so you actually know where each app is
From you
  • Signed payer apps
  • Updated CV + licenses
  • Quick replies to our pings
From us
  • Submit + chase every payer
  • Re-credential before expiry
  • Escalate when payers stall
⤓End of Act I — Once you're in-network, real clients can walk in the door.
IIAct II · Stages 4–7

Operations. Run the weekly engine.

Stage 04 / 09· Act II · Operations
Benefits + Intake

Bring on new clients without surprise denials later.

Without us · the leak
$3–8k
per uncovered client, often unrecoverable
With us · the fix
<24h VOB
every client verified before their first session
Same day VOB · 24h family summary·Owner: Billing4ABA·Cadence: Every new client
Where revenue leaks

Sessions delivered to a client who wasn’t actually covered — and a parent surprised by a bill because no one ran a first.

What we run for you
  • before the first session
  • Plain-English responsibility summary for families
  • Intake checklist so nothing reaches billing half-done
From you
  • Client demographics
  • Insurance card front + back
  • Referral / Rx if needed
From us
  • Live VOB with the payer
  • Family-friendly cost summary
  • Intake-to-billing handoff
↓Coverage confirmed — now lock in the hours you can actually bill.
Stage 05 / 09· Act II · Operations
Authorizations

Have every hour authorized before it's delivered.

Without us · the leak
5–15% of revenue
lost weekly to overruns and lapsed auths
With us · the fix
Zero lapses
every reauth flagged 30 days before expiry
Submitted within 48h of assessment·Owner: Billing4ABA·Cadence: Initial · concurrent
Where revenue leaks

Sessions stuck in pending-auth purgatory — delivered but unbillable. slipped, units overrun, and nobody noticed until the EOB came back.

What we run for you
  • Initial and concurrent auth requests submitted on time
  • Tracking of units used versus units approved
  • reminders before they expire, not after
From you
  • Assessment + treatment plan
  • Clinical notes for reauth
  • Service location info
From us
  • Submit initial + concurrent auth
  • Track every unit
  • Reauth 30 days early
↓Hours are approved — now turn delivered sessions into clean claims.
Stage 06 / 09· Act II · Operations
Clean Claims

Send claims that get paid the first time, every week.

Without us · the leak
8–18% denied
industry first-pass denial rate without scrubbing
With us · the fix
96% clean
first-pass clean rate, submitted weekly like clockwork
Weekly batches · every Monday·Owner: Billing4ABA·Cadence: Weekly batch
Where revenue leaks

Bad , wrong , mismatched units — silent rejects that age into denials no one comes back to.

What we run for you
  • Pre-submission scrubbing against payer rules
  • ABA-specific and logic baked in
  • Weekly submission cadence — not "whenever we get to it"
From you
  • Signed session notes
  • Provider + supervisor info
  • Any scope changes
From us
  • Scrub every claim
  • Apply ABA modifiers + POS
  • Batch + submit weekly
↓Clean claims out. Now chase down the ones payers fight.
Stage 07 / 09· Act II · Operations
Payments + Denials

Get paid on every claim — including the ones payers fight.

Without us · the leak
$15–40k / qtr
lost to abandoned denials in a mid-size clinic
With us · the fix
82% recovered
of denials worked within 5 business days
Denials worked within 5 business days·Owner: Billing4ABA·Cadence: Continuous
Where revenue leaks

Denials piling up. Nobody calls the payer. Money ages past and disappears for good.

What we run for you
  • Every denial worked, not parked
  • Appeals with the right clinical and coding language
  • Posting and reconciliation against your
From you
  • Forward payer letters fast
  • Clarify clinical questions
  • Sign appeal forms
From us
  • Work every denial
  • Draft + file appeals
  • Post payments to your AR
⤓End of Act II — Cash starts landing on a predictable cadence.
IIIAct III · Stages 8–9

Scale. Grow without breaking.

Stage 08 / 09· Act III · Scale
Stable Billing

Reach a billing rhythm that runs every single week.

Without us · the leak
Monthly panic
tens of thousands swinging week to week
With us · the fix
Predictable cash
weekly aging report you can actually read
Reporting every Friday·Owner: Billing4ABA·Cadence: Weekly reporting
Where revenue leaks

Cash flow that swings tens of thousands week to week for no clear reason — aging quietly into the 90+ bucket while you focus on clinical work.

What we run for you
  • Weekly aging report in plain English
  • Trended collections vs. expected
  • A real billing partner — not a black box
From you
  • Read the Friday report
  • Flag anything weird
  • 15-min monthly review call
From us
  • Run AR aging buckets
  • Chase 60+ day balances
  • Trend collections vs target
↓Stable rhythm means you can finally hire and grow.
Stage 09 / 09· Act III · Scale
Growth

Hire BCBAs, take more families, open the next location.

Without us · the leak
$18–30k
per new BCBA who sits unbillable for a quarter
With us · the fix
Billable Day 1
new BCBAs pre-credentialed before their start date
New BCBA billable by day 1·Owner: Founder + Billing4ABA·Cadence: Per hire · per site
Where revenue leaks

Growth that breaks billing — new unable to bill for 90+ days while overhead climbs.

What we run for you
  • Credential new before their start date
  • Billing capacity that scales without re-hiring
  • Reporting your bank, board, or partners actually trust
From you
  • Hire date + payer mix
  • New BCBA license + CV
  • Heads-up on new locations
From us
  • Pre-start credentialing
  • Scale billing capacity
  • Investor-grade reports
One free call · no lock-in

Tell us where you are on the cycle.

We’ll show you exactly which stage is leaking revenue today — and what it would take to close it. Even if we never work together.

Book a free billing reviewRead the field notes