An ABA Network Was Using the Wrong CPT Codes for 18 Months. $312,000 in Denials. Two Code Changes Fixed It. Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION This ABA network had grown from 2 to 7..

44% Prior Auth Denial Rate at a Texas TMS Practice With Mid‑Treatment Reversals Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION TMS therapy reimbursement depends entirely on prior authorization, and prior authorization for TMS depends on meeting..

A Nevada Detox Facility’s Denial Rate Hit 41%. The Root Cause Was a Single Missing Field on Every Claim. Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION This 18-bed medical detox facility had operated for three years…

37% of Claims Denied for Medical Necessity in an Adolescent Residential Program: What the Notes Lacked Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION This adolescent RTC had 24 beds, a full clinical team, and strong family..

An Ohio ABA Network Was Losing $47,000 a Month to Auth-Related Denials. The Fix Took 5 Weeks. Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION Four-clinic ABA network, 18 BCBAs, serving approximately 210 active patients across Central..

22% Denial Rate. Six Therapists. One Fixable Process Costing $340,000. Table of Contents The Situation What Was Actually Wrong What We Did The Results THE SITUATION Four years in business. Full provider schedules. Strong referral pipeline from three local school systems. Their billing coordinator was..