5 Proven Fixes for ABA Therapy Billing Delays: How to Get Paid Faster with TherapyPM?

Struggling with ABA Therapy Billing Delays? You’re Not Alone.
ABA therapy billing delays don’t just impact cash flow — they interrupt your entire workflow, frustrate your staff, and ultimately affect patient care. Whether it’s missed authorizations, outdated CPT codes, or poor follow-ups, many practices lose weeks—or even months—waiting on reimbursements.

But the good news? These delays are preventable. By identifying the root causes of ABA claim denials and automating your revenue cycle with the right therapy billing software, you can eliminate inefficiencies and get paid faster.

In this blog, we’ll walk you through 5 proven fixes to common ABA therapy billing issues and show how a platform like TherapyPM can help you reclaim control of your revenue cycle—without adding extra staff or stress.

Key Takeaways

• ABA therapy billing delays are preventable by addressing workflow gaps – missed authorizations, coding errors, and payer rule violations. 
• Use TherapyPM to automate billing processes, such as tracking authorizations, validating claims, and sending real-time denial alerts. 
• Standardizing the billing process across team members reduces errors and improves therapy billing reimbursements, claim submissions, and consistency. 
• Proactive ABA billing denial management helps recover revenue faster, such as knowing when to escalate, appeal, or resubmit with supporting documentation.
• Monitoring claim aging and billing metrics shows information about bottlenecks, helps improve billing strategy, and stabilizes cash flow. 
• TherapyPM simplifies ABA therapy billing end-to-end with built-in tools designed specifically for ABA and multi-specialty therapy practices. 

Red Flags That Signal Deeper Issues 

Often, therapy practices face issues with billing, and even when they fix the issues, they reoccur again. Why? There are a few underlying factors and root causes that practices should be aware of, so they can fix the issue before it gets worse. Here are a few red flags that signal deeper issues:

Red Flags	How do They Show Deeper Issues?
Recurring Denials for the Same Codes or Reasons	Missing modifiers or expired authorizations
High Volume of Aged Claims (Over 60 Days)	Poor follow-up, missing documentation, or delayed submissions
Frequent Resubmissions or Corrections	Inefficient front-end checks and lack of automation
Delayed Prior Authorizations	Missed or expired authorizations
Inconsistent Use of CPT Codes and Modifiers	When different billers use different codes for just one service, it causes a lack of standardization.
Unclear or Disorganized Billing Workflow	Miscommunication among team members, and not knowing who’s doing what or when
Frequent Patient Inquiries About Billing Issues	Claim follow-up gap especially when patients ask why their insurance hasn’t paid them yet.
Untracked Denials or No Appeals Process	Unfollowed or forgotten claims.

Common ABA Therapy Billing Workflow Mistakes

Making mistakes is a human thing to do, however, persistent mistakes can be a cause of concern for therapy practices. Even a single mistake can result in claim denials and delays. Therefore, therapy practices must stay aware and informed about the common ABA therapy billing workflow mistakes:

Missed/Expired Authorizations

Failure to track authorization start/end dates or approved session limits can result in ABA claim denials, even with correctly provided services. This happens often due to manual tracking or lack of automated alerts. 

Late Claim Submissions

Factors like staff backlog, incomplete notes, or unclear workflows can cause significant delays in submitting ABA claims. This can push claims past timely filing deadlines, causing permanent revenue loss. 

Incorrect Modifier Usage for ABA Sessions

Using the wrong or missing modifiers, such as HO, HM, or 95 for telehealth, can result in ABA claim rejections. This can harm especially payers with strict ABA coding requirements. 

Overlooking Payer-Specific Rules 

It is easier to assume all payers follow the same coding or documentation guidelines, giving rise to errors in decision-making. In reality, each insurer requires different combinations of CT codes, modifiers, and clinical notes. 

How to Fix Persistent ABA Claim Delays?

Delays don’t just happen during the payout stage; rather, they are already deep-rooted in your workflow from the beginning. The first three fixes focus primarily on stopping the claim delays before they even begin. 

Here’s how to reduce ABA billing delays by fixing them effectively:

Fix #1: Automate Authorization Tracking Therapy Billing 

“Never miss another expiring authorization.”

Problem: ABA claim denials often occur due to expired or missed authorizations. Manual tracking methods like sticky notes or spreadsheets are often unreliable and prone to human errors. 

Solution: ABA therapy practices should implement automated authorization tracking therapy billing with real-time visibility and expiration alerts. They can rely less on spreadsheets and manual follow-up while improving therapy billing reimbursements, compliance, and preventing lost revenue.

Fix #2: Use Pre-Submission Error Checks

“Avoid ABA claim denials before they happen.”

Problem: ABA claim denials often occur due to preventable errors, such as incorrect modifiers, missing patient data, or outdated CPT codes. Validating every claim manually is slow, inconsistent, and prone to oversight. 

Solution: Implement automated pre-submission claim validation that detects errors before you submit the claim. It is vital to catch and correct issues earlier to prevent delays, reduce reworks, and improve your clean claim rate. 

Fix #3: Standardize Billing Protocols

“Don’t let inconsistency cause delays.”

Problem: Each biller is different; therefore, they have their own set of workflows, coding conventions, or submission timelines. This leads to inconsistent billing, increased errors, and longer reimbursement cycles. 

Solution: Standardize your ABA therapy billing workflow with predefined protocols and templates. Establish consistency in CPT code usage, modifiers, session documentation, and submission timing across your entire team. 

Fix #4: Set Up Denial Alerts & Escalation Steps

“Don’t wait to act on ABA claim denials – act fast!” 

Problem: Many practices lose their revenue due to untracked ABA claim denials or late responses to rejections. Without a clear follow-up process, appeals get missed, and therefore, claim denials stay unresolved. 

Solution: Use an ABA billing denial management system that provides real-time denial notifications. Create an internal workflow to escalate and respond to rejections immediately. Timely action will improve therapy billing reimbursements while reducing financial loss. 

Fix #5: Track Metrics and Claim Aging 

“If you can measure it, you can fix it.”

Problem: It is extremely difficult to identify bottlenecks or take corrective action without visibility into claim aging and payment trends. Aged claims and delayed cash flow can silently destroy your ABA practice’s financial health. 

Solution: Monitor ABA therapy billing KPIs such as claim aging, denial rates, and reimbursement timelines via a centralized dashboard. Using the right metrics, you can identify issues faster, while optimizing your ABA therapy billing strategy for better cash flow. 

Escalation Tips Therapists Can Use Themselves 

If you are a solo therapist or part of a small team, you may feel overwhelmed to deal with ABA claim denials or delays. However, there is no need to worry as you can take full control of the process with the simple escalation steps:

Always Review the Denial Code First:

Check the EOB (Explanation of Benefits) or ERA for ABA claim denial reason codes. These codes will show you reasons why the claim was rejected, such as, missing modifier, expired authorization, or something else entirely. Additionally, keep a cheat sheet of common ABA denial codes and their meanings handy, to act faster next time. 

Call the Payer Directly:

In case the denial reason seems to be unclear/incorrect, call the insurance provider and ask them for a detailed explanation. Remember to document the call, including the rep’s name, date, and information that was discussed. It helps during the time of appeals and creates a record of persistent issues. 

Submit a Formal Appeal (If required):

If the ABA claim denial was due to factors not within your control, such as payer error or misapplied rule, please file an appeal immediately. Also, record all necessary documentation such as:

1. Session notes
2. Authorization proof
3. Corrected claim form.

Note: Stick to payer timelines, as some payers allow only 30-60 days for appeals. 

Resubmit Corrected Claims Promptly:

If you detect a minute error like wrong code or missing info, remember to correct the claim and resubmit it immediately. Fixing errors earlier can improve your therapy billing reimbursements, and help you get paid faster. Also, use claim validation tools to avoid repeating the same mistake. 

Track ABA Claim Denials & Responses in a Log:

You can create a claim denial resolution which can help you track:

1. Dates of denial
2. Reasons
3. Actions taken
4. Resolution outcome

Note: This not only keeps you organized but also helps identify repetitions in issues/payers with higher rejection rates. 

Escalate to a Supervisor (If required):

If the claim remains unresolved despite multiple follow-ups, please escalate the issue by requesting to a payer supervisor/escalation specialist. It can be helpful to remember the golden rule: Be polite but persistent. Also, having the documentation ready can make your case stronger. 

Know When to Escalate Internally Too:

If you are part of a small team, communicate delays with your admin/billing partner. Inform your team earlier so everyone can resolve issues faster and prevent future ones. 

How TherapyPM Simplifies and Accelerates Billing End-to-End?

TherapyPM is an all-in-one therapy billing software designed to streamline daily admin and billing tasks for therapists. The software caters to multidisciplinary therapists – ABA, mental, physical, speech, occupational, and pediatric. 

The therapy billing software reduces billing-related issues at every stage of the revenue cycle. It offers smart tools that work behind the scenes to streamline your entire workflow. 

TherapyPM will show you exactly how to reduce ABA billing delays:

Authorization Management

• Smart Authorization Tracker: TherapyPM has a built-in authorization tracking system that records:
• Start and end dates of each authorization
• Approved number of units or sessions
• Associated CPT codes and payer details 

Whenever therapists schedule a particular session or prepare for billing, they can instantly identify whether the session is covered under valid authorization. The authorization tracking therapy billing software reduces the chances of rejection, hence improving the quality of care. 

• Expiration Reminders: To protect your practice from spiraling further, TherapyPM sends automated alerts to your team as the authorization dates get closer. The therapy billing software sends the following reminders:
• Advance notifications (e.g., 15, 7, and 3 days before expiry)
• Alerts for sessions getting closer to maximum units
• Reminders to request renewals proactively. 

These expiration reminders allow your billing or admin team to initiate reauthorization before coverage lapses, hence preventing denied claims from timing gaps. 

• Auto-Blocks Scheduling Beyond Valid Dates: TherapyPM enables therapists to avoid accidental scheduling errors effectively. The authorization tracking therapy billing software ensures that therapists don’t schedule sessions apart from the valid authorization dates/beyond the approved session count. Here’s how:
• Book only within the covered periods
• Admins can request new authorizations when required 
• Stay compliant with payer rules and reduce audit risk

This ABA therapy billing feature is a safety net that prevents billing mistakes before they happen. Just like the saying, “Prevention is better than a cure”.  

Clean Claim Creation

• Pre-Submission Claim Scrubber: TherapyPM has a built-in claim validation engine that automatically scans every claim for:
• Missing patient details 
• Invalid or mismatched CPT codes
• Incomplete documentation
• Incorrect or missing modifiers
• Payer-specific coding issues

The therapy billing software alerts you about any incorrect claims before they reach the payer. This gives therapists enough time to correct any errors before submission to claim denials and delays. 

• Payer-Specific Rules Built-In: Insurance companies have specific rules, for instance, some companies require modifiers for ABA services, while others have limits on code combinations. TherapyPM includes payer-specific logic, so it knows exactly what’s allowed and what’s not. The therapy billing software updates payer rules regularly, ensuring:
• You don’t necessarily have to memorize changing billing policies
• Your claims stay compliant, even when rules change
• You reduce denials based on outdated payer preferences. 
• Real-Time Error Alerts: While creating a new claim, TherapyPM flags errors in real-time and allows you to fix them immediately. This reduces the number of rejections and prevents you from reworking them later. 
• Instant alerts before claim submission
• In-app suggestions for fixing errors 
• Fewer “back-and-forths” with payers

These updates ensure you submit clean claims to payers at the first time, with less rework, fewer delays, and faster reimbursements. 

Standardized Workflows

• Custom Billing Templates: TherapyPM enables you to create pre-configured billing templates based on:
• Session types (e.g., 97153, 97155)
• Duration
• Place of Service (POS) 
• Required modifiers 
• Associated staff or therapist role

These templates ensure everyone bills the same way every time, preventing guesses and inconsistencies. 

• Automated Code Application: TherapyPM automatically applies CPT codes and required modifiers based on:
• Service type
• Provider credentials 
• Payer requirements

The therapy billing software ensures compliance and reduces human error, especially when handling multiple payers with different coding rules. 

• Team-Wide Billing Protocols: TherapyPM consists of a wide range of billing protocols that can help therapists:
• Assign billing roles
• Lock templates to prevent unauthorized changes
• Set rules around submission timing and approval processes. 

This ensures all therapists follow the same workflow, regardless of who is in charge of the task. 

ABA Billing Denial Management

• Real-Time Denial Alerts: As soon as TherapyPM detects a claim denial, it notifies you immediately with an alert on your dashboard. It shows:
• Denial reason codes
• Payer messages
• Affected service lines. 

The therapy billing software ensures you never wait longer for EOBs or scour through PDFs anymore. 

• Guided Denial Management Tools: TherapyPM has denial management tools that enable you to act on claim denials as fast as you can, such as:
• Suggested next steps for common denial types 
• In-app notes to track appeal progress
• Ability to resubmit claims directly from the platform

The software ensures your team can work smarter, not harder, and avoid missing appeal deadlines. 

• Track Denial Trends Over Time: Practices can fix billing delays on a large scale by spotting the claim denial pattern, and not just one denial. With TherapyPM, you can view:
• Denials by paper
• Common denial codes
• Frequency by service type or staff

The software helps you fix root causes and improve your approval rate in the long run. 

Performance & Cash Flow Visibility

• Claim-Aging Dashboard: TherapyPM offers an interactive aging report that shows:
• Claims by aging buckets (0-30, 31-60, etc.)
• Outstanding payments 
• Payer performance metrics

Using this information, therapists can prioritize follow-ups and focus on the claims that matter the most. 

• Payment & Reimbursement Trends: TherapyPM enables therapists to view payment and reimbursement trends such as:
• Average time to payment by the payer
• Revenue by CPT code or provider 
• Historical claim processing performance

Make smarter decisions such as switching payers, adjusting billing timing, or renegotiating contracts. 

• Cash Flow Forecasting: TherapyPM has cash flow forecasting tools that help predict incoming payments and allow therapists to:
• Plan payroll
• Invest in team or tools 
• Prevent cash crunches

The software ensures you have a user experience that is similar to a financial GPS. 

Conclusion

ABA Therapy Billing Delays do not just interrupt cash flow, rather, they also affect your ability to focus on patient care and expand your practice. However, the majority of these delays are preventable. You can significantly reduce ABA claim denials and improve therapy billing reimbursements by addressing root causes – missed authorizations, coding errors, and inconsistent workflows. 

TherapyPM is a smart and intuitive therapy billing software that streamlines your daily admin tasks. It ensures you no longer juggle spreadsheets, chase payers, or doubt compliance. From real-time denial alerts to pre-submission checks and claim aging insights, submit faster, reduce denials, and improve therapy billing reimbursements. 

Why wait for months for payments when you can speed up your entire ABA therapy billing process today? Start your 30-day free trial with TherapyPM today, because getting paid shouldn’t be a waiting game anymore! 

Frequently Asked Questions (FAQs)