ABA Billing: Back to Basics

Description
In this episode of the ABA Business Leaders Podcast, hosts Stephen and April Smith break down one of the most critical — and often misunderstood — parts of running an ABA business: billing.
From choosing between in-house and outsourced billing to understanding payer contracts, they explore the practical steps that help your clinic stay compliant, efficient, and profitable. Stephen and April share hard-earned lessons about reading contracts carefully, negotiating rates, maintaining control over your billing process, and tracking denials to spot inefficiencies before they snowball.
Whether you’re just getting started or looking to clean up your current systems, this episode will help you take a closer look at your billing practices and ensure your business’s financial health is as strong as your clinical outcomes.
Key Takeaways
Your billing setup isn’t permanent. You can start in-house and later outsource—or vice versa. What matters is choosing the system that best fits your growth stage.
Always read your contracts. Never sign a payer agreement without understanding every clause, rate, and responsibility. Every business partner should be knowledgeable about what they’re agreeing to.
Know your minimum rates. Rate negotiation might not happen in your first contract, but understanding what you can’t afford to accept is vital to staying sustainable.
You can’t hand off full control. As April puts it, “Nobody will care about billing as much as you do.” Even if you delegate billing tasks, you need oversight and involvement to prevent problems.
Track patterns and denials. Billing data tells a story—watching for repeated denials or errors helps you catch process issues before they become expensive.
Clean billing builds value. When it comes time to sell your ABA business, well-organized, transparent billing records will give potential buyers confidence and increase your valuation.
Sponsored by Silna
This episode is sponsored by Silna, the first-ever Care Readiness Platform built specifically for ABA.
Silna automates prior authorizations, benefit checks, and insurance monitoring to ensure your patients are financially cleared for care before sessions begin. Operating in 45+ states and serving over 50,000 patients, Silna helps ABA providers save thousands of hours by verifying eligibility, tracking expiring authorizations, and using AI to complete and submit all ABA-related authorization types.
👉 Learn more about how Silna can help you spend more time with patients and less time on paperwork: https://3piesquared.com/business-affi...
Resources & Links
Stay ahead with practical insights from the ABA Business Leaders Podcast:
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Wondering how to start an ABA business or how to know your ABA business is ready to scale? Take the free ABA Business Readiness Assessment:
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Need straightforward ABA billing tips to keep your cash flow healthy? Grab the quick guide here:
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