ABA Billing Compliance Consulting

 In today’s healthcare environment, compliance is not optional, it’s essential. Our Billing Compliance Consulting service is designed to help ABA therapy providers operate with confidence, reduce the risk of payor audits, and avoid costly recoupments. 

 We perform a thorough review of your billing procedures, documentation practices, and payor-specific requirements to identify compliance gaps and recommend corrective actions. Our consulting is practical and actionable, giving you clear steps to strengthen your processes and protect your revenue.

Our focus areas include:

• Internal Billing Compliance Reviews – Assess current processes for adherence to federal, state, and payor guidelines.
• Policy & Procedure Evaluation – Ensure your billing policies align with payor contracts, Medicaid rules, and industry standards.
• Audit Preparation & Support – Help you get “audit ready” by reviewing documentation, coding, and claim submission history.
• Payor-Specific Compliance Guidance – Navigate unique requirements for Medicaid Managed Care plans and major commercial payers.
• Ongoing Compliance Monitoring – Establish internal checks to maintain accuracy and compliance long-term.

Billing compliance protects your agency from payment recoupments, fraud allegations, and contract terminations. Even unintentional errors, such as incorrect modifiers, lack of required documentation, or billing beyond authorized limits, can trigger costly consequences. Our consulting ensures your billing is both accurate and defensible. 

 We offer two flexible service options to fit your agency’s needs:

• Compliance Advisory Hourly Consultations – Ideal for agencies that need expert guidance on specific compliance concerns, policy clarifications, or payor requirements without committing to a long-term contract. You control the agenda, and we provide actionable recommendations during focused, hourly sessions.
   
• Project-Based Internal Audits – A comprehensive review of your billing workflows, claim submission practices, documentation, and payor compliance across a defined scope and timeframe. Each audit includes a detailed findings report, risk assessment, and corrective action plan to strengthen compliance and reduce audit risk.
   

Whether you choose advisory consultations, a full internal audit, or a combination of both, our approach is hands-on, detailed, and tailored to your ABA agency. We offer both virtual and onsite services, delivering practical, compliance-focused strategies you can implement immediately to protect your revenue and operate with confidence.