5 Tips for Transitioning From Manual ABA Billing

After 12 years in this industry, I've helped dozens of ABA clinics ditch their paperwork nightmares for streamlined systems that actually work. This isn't just about fancy software—it's about getting your therapists back to doing what they love instead of drowning in paperwork.

Start With an Honest Look at Your Current Billing Mess

You wouldn't believe how many practice owners tell me "our billing is fine" right before showing me a 40% denial rate! Before we touch any new system, we need to see what's really happening in your practice.

When I visited Mountain View Therapy last fall, their billing coordinator, Jenny, was working weekends just to keep up. Their biggest payer was rejecting claims left and right. Turns out they were using modifier codes from 2018! Once we spotted that simple issue, their rejections dropped dramatically.

The real problems are usually hiding in plain sight:

• Which insurance companies are giving you the biggest headaches

• Where your money is getting stuck in the pipeline

• How much overtime is your team putting in just to stay afloat

Don't Settle for Generic ABA Billing Software

Look, QuickBooks might be great for your accountant, but it's a nightmare for ABA billing. You need something built for our world.

I remember when Westside Behavioral first called me—they'd just spent $15,000 on a "healthcare billing system" that couldn't handle authorization tracking. Total disaster.

Your software absolutely must handle:

• The unique service codes we use in ABA therapy

• Those frustrating authorization requirements that change by payer

• Notes that actually connect to your billing (so you're not doing everything twice)

When Bright Horizons ABA switched to a specialized system in January, their biller Lisa texted me: "First time in 5 years I didn't work a Saturday. The system caught all the authorization issues BEFORE submission!"

Your Team Will Resist Change (Plan For It!)

People hate change. I've walked into practices where staff were practically staging mutinies over new systems.

At Sunshine ABA, their office manager, Maria (who's been there forever), was convinced she couldn't learn new technology. We took it slow:

• I sat with her for hands-on training using her actual clients

• We made simple guides for just the tasks she does daily

• I paired her with younger staff who could help when I wasn't there

Two months later, Maria told me, "I was ready to quit over this, but now I'd never go back to the old way."

Protect Your Data Like Your Practice Depends On It (Because It Does)

This is the scary part that keeps me up at night. Your client data and billing history aren't just files—they're your practice's lifeblood.

I got a panicked call at 9 pm from a practice owner who tried migrating data themselves. They lost authorizations for 35 clients and couldn't bill for services already provided. That's tens of thousands in revenue gone.

When we handle migrations, we're absolutely obsessive:

• We run old and new systems side-by-side for at least two weeks

• Every single authorization gets triple-checked

• We verify your top 20 clients' data personally with you

After we moved Oceanside ABA's data (211 active clients!), their director, Sarah, actually hugged me. "I expected a disaster and didn't lose a single hour of billable time."

Your ABA Billing System Needs Regular Check-ups Too

Once everything's running, the practices that really win are those that keep fine-tuning.

My client, Jack in Boston, has his team do a quick weekly review:

• They check why certain claims took extra time

• They spot-check EOBs against what was expected

• They catch payer policy changes before they become problems

Jack's practice went from a 22-day average payment time to just 9 days. That's cash flow that transformed his business.

Real Questions From Real Practice Owners

Will our claims get rejected during the switch?

I'm not gonna lie—there's always a risk during transition. But here's what we do to minimize it:

• We run your first 50 claims through extra verification

• Someone from your team who knows your payers reviews everything

• We jump on rejections immediately, before they pile up

Most practices see their clean claim rate improve within the first month, not get worse.

How do we pick from all these software options?

This drives people crazy! Ignore the sales pitches and focus on:

• Does it play nicely with your current practice management system?

• Can real humans help you when things break?

• Will it grow with you or hold you back in a year?

I just helped CrossRoads ABA choose between three options. What sealed the deal wasn't the price—it was calling support at 6:30pm and getting a real person who solved their problem on the spot.

We barely have time to breathe—how can we handle this transition?

This is the most honest question, and I respect it deeply. Here's the reality:

• Small practices typically need 4-5 weeks with focused attention

• You'll need at least one team member who can dedicate 5+ hours weekly

• The practices that try to rush it always regret it

Remember Mountain View? They assigned their senior RBT Jamie, just 5 hours weekly, to focus on the transition. They were fully switched over in 5 weeks with minimal drama.

Let's Get Your Time Back

I started Cube Therapy Billing after watching my sister's ABA practice nearly collapse under billing stress. She was an amazing clinician, spending 70% of her time on paperwork.

When you're ready to make this change—whether that's tomorrow or six months from now—I'm here to walk alongside you. No cookie-cutter approach, just practical solutions built around how your clinic actually works.

Your practice deserves to focus on changing lives, not fighting with insurance companies.