In this Raven Health webinar, Tim Crilly sat down with Matt Zabolotny, founder and managing principal at exydoc, to discuss effective strategies for contracting and credentialing in ABA practices. Credentialing can be daunting, especially for new practice owners, and Matt provided invaluable tips for navigating this process smoothly.
Key Takeaways: Credentialing & Contracting Matt emphasized the importance of identifying the largest insurers in your state and starting with those networks. Focus on becoming in-network with a handful of major payers to maximize revenue without overwhelming your billing processes. Matt also warned against relying solely on being out-of-network, as it can create financial complications for both your practice and your clients.
Stay Persistent Credentialing timelines vary from 30 to 120 days depending on the insurer, so Matt encouraged new business owners to start as early as possible. He stressed the importance of persistent follow-up – networks can open unexpectedly, and checking in frequently can pay off.
Mistakes to Avoid One of the most common mistakes Matt sees is failing to collect client financial responsibilities. For private insurance clients, it’s crucial to set up systems to track co-pays and deductibles – failing to do so can drastically impact your revenue.
Final Thoughts Credentialing is essential for getting paid, and missteps can lead to denied claims and lost revenue. For new ABA practice owners, Matt recommends getting help when needed and focusing on becoming in-network with key insurers to secure a stable financial footing.
In the latest Raven Health webinar, Tim Crilly sat down with consultant Ivy Zwicker, who shared her insights on how ABA practice owners can successfully grow their teams while ensuring financial health. With over a decade of experience in the ABA industry, Ivy’s expertise helps businesses navigate the challenges of sustainable growth.
Key Takeaways: Financial Health & Growth Ivy introduced the concept of ‘No Margin, No Mission,’ emphasizing the importance of maintaining financial stability to keep the mission of helping families alive. While passion drives ABA practices, the financial component ensures longevity. Ivy recommended performing a market analysis when expanding into new areas, ensuring that there is not only client demand, but also enough RBTs and BCBAs to support your services.
Understanding Rates & Caseload Management Ivy highlighted the importance of knowing payer rates and managing caseload metrics. Understanding your reimbursement rates—especially for core services like 97153 and 97155 – is critical to sustaining a healthy business. Additionally, Ivy discussed the need for tracking growth carefully to avoid overstaffing, which could lead to financial strain.
Data-Driven Decisions for Growth Ivy stressed the importance of tracking metrics like authorization utilization and average billable hours. She explained how maintaining data dashboards allows ABA owners to make informed decisions about when to hire more staff and how to optimize their existing teams for both financial and operational success.
Balancing Growth and Client Needs It’s essential to balance client growth with workforce management. Ivy advised owners to carefully analyze their client demographics and ensure they are strategically filling gaps in their caseloads, particularly during underutilized hours, such as mornings and early afternoons.
Final Thoughts For ABA practice owners, Ivy’s advice centers around being realistic with your business growth, tracking the right data, and ensuring financial health from day one.
In a recent Raven Health webinar, Tim Crilly hosted John and Jill Jacobson of J2Jacobson Consulting to share essential advice for starting an ABA practice. Drawing from decades of experience, they offered valuable insights for professionals transitioning from employee to practice owner.
Key Considerations Before Starting The Jacobson’s emphasized the importance of evaluating your motivations. Jill warned that starting an ABA practice isn’t a quick escape from frustration, but a significant commitment. Financial preparedness is critical – Jill advised, “Don’t quit your day job,” stressing the importance of having a strong financial plan and consulting experts beyond ABA clinicians.
Strategic Startup Planning John and Jill stressed the importance of defining your service model – home-based, center-based, school-based, or hybrid – and understanding your market. John pointed out that different regions have varying demands for ABA services, so it’s vital to research and plan accordingly.
Financial Management & Growth A key takeaway was the need for a detailed financial budget and hiring plan. Understanding your break-even point and having a growth strategy in place is essential for long-term success. Jill highlighted the need for smart decisions, especially when scaling from home to center-based services.
Systems & Retention Implementing the right systems at the right time is crucial for managing a growing practice. John also emphasized the importance of staff retention, noting high turnover rates among RBTs. Creating a supportive environment where staff feel valued is key to sustaining your practice.
Final Thoughts For those considering starting their ABA practice, the Jacobsons highly encourage seeking expert advice and planning strategically for success. Interested in learning more? Watch the full, free webinar below: Click here to watch the webinar.
Paraphrasing the old ABA therapy adage, if you gather 100 BCBAs in a room you’ll find 100 unique approaches to treatment. This is both the beauty and the challenge of the field: the need for personalized programs that resonate with the individuality of each client. After all, when no two clients are alike, a one-size-fits-all method just won’t cut it. The very diversity in administration is not a bug; it’s a feature that makes ABA therapy profoundly special and effective.
One Size Fits None: The Dilemma of Standard Data Collection Platforms
Unfortunately, too many data collection platforms in the market haven’t caught up with this reality. They come with rigid programming, offering a set menu of prompts that are about as flexible as a steel rod. Clinicians find themselves in a maze of scroll bars, zoom tools, and endless clicking — all just to input data that should be straightforward. It’s a classic case of the tool defining the craft, not the other way around. This rigidity constrains BCBAs, forcing them into a mold that might not serve.
Tailoring ABA Therapy: Features that Speak ‘Flexibility’
The gold standard for any clinical programming is flexibility. When shopping for an electronic data collection platform, it’s essential to prioritize one that bends to fit your clinic’s needs, not the other way around. Here’s what to look for:
A program library that empowers BCBAs to create new programs from templates or from the ground up.
Mastery criteria and thresholds that are as customizable as your approach to each client.
A customizable prompt library, ready to be tailored to the nuances of specific programs.
A user-friendly interface that not only is a breeze to navigate but also allows clinicians to quickly identify top-performing programs.
Conclusion: The Power of Flexibility in Data Collection
The ubiquity of pen and paper data collection in ABA therapy speaks volumes about the unmatched flexibility it offers. However, the drawbacks of shunning modern data collection platforms far outweigh the benefits of sticking to old methods. As you contemplate integrating a new platform into your practice, weigh the benefits of digital efficiency against the potential for clinical constraint. The right data collection platform should feel like a natural extension of your expertise, not a straightjacket limiting your clinical creativity. So, when you take that step forward, make sure the platform you choose allows your clinic — and your clients — to move with you, stride for stride.
Could today be the day that the stars and the moon have aligned, and you are ready to take the plunge into business ownership? After weighing the pros and cons, you are determined to become the founder of your very own ABA clinic. Congratulations! First step, don’t quit your day job, just yet. Before you fully jump in, let’s make sure you have checked most of the boxes to be ready for self-employment.
Legal entity, business name and structure The type of corporate structure determines your liability, business registration requirements, and how you will file taxes.
Registration, federal and state tax ID, licenses and / or permits LLCs, non-profit entities,or corporations will need to file with the federal government. An Employee Identification Number (EIN) allows you to pay federal taxes and state income, along with employment taxes. Be sure to apply for any required permits or licenses, hire employees, and set up a business bank account.
Determine which type(s) of business insurance you need to start operating General liability insurance vs. property insurance vs. income insurance vs. worker’s comp vs. data breach coverage should be considered depending on the business model, scope, and size of the organization.
Choose a bank and set up a business account Separate business and personal funds, whether for spending or receivables, protect your interests. Be sure to consider personal relationships, potential lines of credit, credit cards, and small business support when choosing your banking institution.
Set up an accounting system Consult with a professional if you do not have the knowledge and experience to be organized and compliant with federal and state tax laws.It is important to establish a system for filing financial statements and reports, as well as tracking profits and losses, based on an annual budget and projections.
Determine which tools, equipment, technology, and electronic platforms are needed to operate the business Whether home-based or center-based, certain technologies and platforms will be necessary to operate the business. Are you a Mac or PC fan? Microsoft vs. Apple platforms will determine, by design, options for business tools and technology resources. Clinical data gathering, billing platforms, monitoring KPIs, HRIS, ATS, and more influence how to document, bill claims, make data-driven business decisions, recruit, select, hire, and document and retain team member information. Don’t be overwhelmed… Remember, start small, think big.
These steps may not seem glamorous or fun, however, it is essential to check the boxes to ensure you are set up to succeed and to protect your personal and professional interests for the long term.
These resources are neither endorsed nor supported by J2Jacobson Consulting, LLC or Raven Health and are simply provided to assist in expediting your research for starting an ABA provider company. We invite you to demo Raven Health ABA EHR and associated tools ABA Data Collection & Practice Management Software | Raven Health and to reach out to J2Jacobson Consulting Home (j2jacobsonconsulting.com) as you launch your journey into entrepreneurship.
Next Up:
The four (4) C’s: cash, credentialing, contracting, clinical model
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