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ABA Therapy News on Medicaid Fraud and Importance of Having Practice Management System in Place

Medicaid Fraud and Importance
Applied Behavioral Analysis (ABA) therapy has been in the news a lot lately because many clinics offering it have come under fire for Medicaid fraud. If you are a clinic that offers ABA therapy, it is more important than ever to have a practice management system in place to help you avoid even the appearance of Medicaid fraud. The government is cracking down on abuses of the Medicaid system and looking particularly at clinics specializing in ABA therapy.

For clinics worried about dealing with Medicaid fraud and interested in learning more about how a practice management system can help, this post provides useful information about potential pitfalls in ABA therapy billing services and the benefits of practice management software.

What are some common problems with ABA billing?

To fully understand what problems can arise with ABA billing, you need to step back and consider what ABA entails. Applied behavioral analysis is a popular and successful type of treatment for patients with Autism Spectrum Disorder (ASD) as well as patients suffering from addiction, brain injuries, or compulsive behavior.

As its name implies, ABA focuses on the behavior of patients and thus requires large amounts of data to record behavioral assessments. ABA has been endorsed by the U.S. Surgeon General, the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the federal Medicare and Medicaid programs.

Along with the popularity of its results, however, ABA clinics are increasingly at risk of being investigated for Medicaid fraud. Some of the most common abuses that have been discovered include the following:

  • Billing more hours than were actually provided
  • Inflating provider credentials
  • Double billing for services
  • Billing for individual therapy when group therapy was provided
  • Billing for services not rendered

To protect your practice from the increased scrutiny that such fraudulent activity has created, consider the following guidelines:

  • Be aware of federal laws related to your practice
  • Be specific and consistent in your coding procedures
  • Be sure to promptly report any errors you discover

If you operate an ABA clinic, you are likely swamped with clients, as the need for such valuable services for children on the autism spectrum has only increased in recent years. The last thing you should be spending your time doing is combing through your records for errors. To maximize your clinic’s profitability, you should focus on what your specialty is and allow practice management software to do the rest.

You can find peace of mind and devote more time to your patients when you implement software programs that streamline your processes and keep you safe from government scrutiny.

What are the benefits of having practice management software?

Whenever you are managing copious amounts of data, you risk losing valuable time trying to organize it in meaningful ways. Especially for clinics offering ABA, you can greatly benefit from having software in place that allows you to seamlessly run your clinic. Amvik Solutions not only offers practice management software but ABA therapy billing services.

Some of its features that are especially beneficial to ABA-focused clients include:

  • Client authorization management
  • Payroll system that integrates third-party providers
  • Provider portal with internal messages, timesheets, and schedule access
  • Ability to calculate provider mileage, drive time, and break time
  • Billing system for private and government pay, and private insurance
  • Staff and client scheduling
  • Automatic categorization of sessions according to CPT Category III codes
  • HR module to track employee credentials
  • Customizable reports
  • Access from any desktop, laptop, or mobile device at any time of day
  • HIPAA compliant
  • Electronic signature ability
  • Document management

To find the best ABA therapy billing services and practice management system for your clinic, contact Amvik Solutions at (805) 277-3392.

Our experienced team is always ready to answer your questions about our range of services for clinics specializing in ABA therapy. Deciding to outsource your data management to a company that specializes in clinics like yours is the best way for your clinic to avoid suspicion of fraud and to provide the attention your clients need. Our webABA software is designed to assist you in tracking your clients from start to finish.