Remote ABA Therapy Webinar

ABA Telehealth Webinar: How to Support Families Remotely

Recorded on: Thursday, March 19th, 2020

Helpful Resources:

In response to the current COVID-19 pandemic, Rethink will be holding a special webinar to help ABA providers support the clients and families they serve through this time of uncertainty.

This webinar will be an overview of ABA telehealth strategies to support families remotely.  We will include best practices from seasoned clinicians in our employee benefits division, who coach and train parents remotely.  An overview of billing codes for telehealth services will also be provided by our business solutions team.

Expect to discuss:

Real-life lessons of a BCBA who has done remote consultation/telehealth with parents

  • Best practices for engaging parents as partners in the treatment process
  • Some tips to remember when starting this type of work will be provided
  • Utilizing video conferencing to work with families

Clinical utilization of the Rethink parent portal, specifically:

  • How to grant parents/guardians access to their child’s Rethink account
  • Resources and Trainings for parents
  • Updating programming and behavior plans to focus on parent training and data collection

Practice Management utilization of Rethink, including how to:

  • Update your Rethink system to account for telehealth modifiers
  • Schedule telehealth
  • Update session note templates for telehealth
  • Where telehealth will be indicated on the billing export

This webinar is free and does not offer CEUs.


Picture of Erin and Diana

Translating Medical Necessity Criteria for ABA Providers

Long-standing research on the effects of ABA services to treat ASD indicates that treatment intensity may greatly influence the response to treatment in children.

As such, clinicians should carefully calibrate and adhere to dosage recommendations.

Studies have concluded that adhering to prescribed treatment dosages, aligned with published research, improves outcome mastery and increases adaptive behavior skills.

Legislative advocacy and policy development efforts in the elimination of managed health plans perceived prescriptive authority over medical necessity determination have been a priority of many clinicians, lawyers and policymakers.

However, understanding the health plan’s role in medical necessity and utilization management, as well as limitations in the ability to conduct well-controlled research on the intensity of treatment recommendation remains a challenge.

Despite best practice standards and available research supporting proper dosage recommendations, the variability in dosage recommendations may still be negatively influenced by a variety of factors.

These include, but are not limited to:

  • A complex language barrier between the clinician and the health plan
  • Lack of clinician training in what is medically necessary
  • Unlawful or otherwise ineffective mandates enforced by funding sources
  • Limitations in applied research 

Prescription fidelity affects both the clinical and operational sides of the effective delivery of autism services.

As the field of Autism Services has continued to grow, the appropriate measures of clinical quality remain embedded in providing the adequate intensity of service on the individual patient level.

The drastic under-prescribing of care, that is industry-wide, affects the ability for patients to receive optimum results.

It also creates additional administrative costs and burdens on autism providers, which results in scaling and fiscal management challenges.

To continue the conversations related to the medical necessity of autism treatment, the development of a medical necessity review tool may lend guidance for clinicians.

This will help them move toward consistency in considerations of medical necessity justification and appropriate dosage.

To register for this event: Click Here


social media platforms for aba therapy

Best Social Media Platforms for Your ABA Therapy Business

For many ABA therapy businesses, promoting their services is often done through traditional marketing methods and word of mouth.

That said, we’re seeing more and more practices starting to embrace online marketing initiatives.

You can’t talk about successful online marketing without the use of social media platforms.

Social media can be a powerful asset for your ABA therapy business and when harnessed correctly, it can exponentially grow your reach online.

If you don’t have much experience of marketing your ABA therapy business on social media, the thought of getting started can feel daunting.

To help clear things up and arm you with the information and insights you need, we’ve put together this guide.

Read on to find out about the best social media platforms for your ABA therapy business to use.

Why Social Media Matters for You

If your business wants to find new people to work with and new patients interested in what you’re offering, it’s important to reach out to people and to get your name out there.

Lots of daily activity that happens on social media, which is why your business needs to be active and part of the conversation.

Social media is about more than the normal personal things we all share, like what you ate for breakfast or what new album you are listening to.

It’s also space for businesses to connect with customers and to build a following that’ll help them grow over time.

With the right approach and quality content, you’ll connect with lots of people who wouldn’t otherwise have known your business even existed.

Identify Your Goals

Before you can construct an effective social media strategy, you first need to clearly identify your goals and what you want to achieve.

The right approach will only be found when you know which outcomes you and your team are working towards.

For some professionals, that might be about expanding your reach, for others it could be about recruiting or making industry connections and contacts.

These are very different aims and will require different approaches to social media.

The content that will land well with industry professionals will have a different, more specialized and informed tone than the content parents interested in your services might enjoy and benefit from.

Different social media platforms will be well- or not so well-suited to various goals and approaches.

Below, we’ll talk about the best platforms available and what they can offer below to help you get an idea of which of them will benefit your business most.

Which Platforms You Should Consider Using

Here’s more information about each of the top social media platforms, what they’re good for and why you should (or shouldn’t) use them.

From there, you can decide which you think will best suit your ABA therapy business and what you want to achieve going forward.

Twitter

If you have an existing audience, Twitter is a good platform to make use of.

It’s the platform to use if you’re looking to stay on top of trends that are being talked about by users online and around the globe.

If you’re not looking to make use of trending topics as a way of promoting your business, and don’t already have an established audience, Twitter is not the ideal platform for you to focus your efforts and attention on. 

If you use Twitter, be sure to stay on top of new conversations and remember to take a unique approach each day.

Trends emerge out of the blue, and if they’re relevant to your business, be fast in leveraging them appropriately to your marketing advantage.

Instagram

Instagram is the most visual social media platform, and that’s why it’s ideal for giving customers a glimpse of what your business does.

That said, it can be a hard platform to master, as a cohesive and visual aesthetic is essential.

It’s about creating captivating images that grab the attention of parents who might be interested in the services you offer.

It tends to be a younger audience on this platform, but there’s a good range of ages for you to appeal to with the right images and graphic content.

Creativity will be key when using Instagram, so don’t shy away from expressive content that goes beyond what you might create for other social media platforms.

It’s about drawing people in and making people take notice.

When you’re competing for attention on a platform like Instagram, only visually engaging and thoughtful content will cut through the way you need it to.

Facebook

Facebook is by far the biggest social media platform out there right now, and businesses of all kinds should be using it.

For the best outcomes, it makes sense to use paid promotions to increase the reach of your Facebook page and get more people visiting it and interacting with it.

You should remember that for many adults, a Facebook page will be the first glimpse people will have of your business. 

First impressions matter when marketing your business on social media.

Ensure your business comes across in a way that’s presentable and establishes a tone that’s appealing and appropriate for the audience you’re looking to engage with.

LinkedIn

LinkedIn is the platform to use if your focus is on recruiting new staff to work for your business.

It’s also good for making industry contacts that might aid your business in one of many potential ways.

Content produced for this platform should be professional and use a tone that suits that kind of audience.

It might not be a platform you feel a need to use urgently, but it might be something to look into when your business expands, especially with its organic reach at an all-time high.

Having strong industry contacts and a professional presence online within that industry is recommended to grow your ABA therapy business.

What to Post and What Not To

What you post (and what you don’t post) on your social media channels will depend on several factors.

It’s important to put in place a strategy that you can follow consistently, taking into account the aims of your business and what you want to achieve.

If you’re looking to connect with more parents, sharing content and posts relevant to them, such as articles or videos about parents of children on the autism spectrum, will generate more engagement and social shares.

Be Specific

It’s also important to tailor your posts and content to the platform you’re using.

Each social media platform has its own quirks and particularities, as we described above.

You should cultivate an approach that suits the medium for the best outcomes.

What you post on Instagram, for example, will need to be different to what you post on Facebook.

That’s because of the different constraints as the platform, as well as differing audience expectations.

Follow Trends and Leverage Video

It’s wise to engage with tending articles, topics and viral videos that have relevance to your message and the ideas you’re trying to convey to your audience.

Creating your own original content is important too, and there are many ways to do so.

When people are scrolling through post after post, video content that makes them stop and take notice, but it still takes a balanced approach to be successful.

Recognize Relevant Awareness Days

There’s an awareness day for just about everything nowadays, and they can offer fantastic opportunities for businesses like yours.

When a relevant holiday or awareness day rolls around, be sure to make the most of it.

Put your business at the forefront of the conversation that’s taking place that day and have pre-prepared content that people can engage with.

People will be much more receptive to your ideas and your messages when there’s a reason for them to do so, such as a day that they feel is important.

What Else You Should Know About Marketing Your Business on Social Media

Now you know which platforms to use and what type of content to post.

We have a few more tips that can help you be more efficient with your social content and engagement strategy.

Consistency

As we’ve briefly mentioned above, consistency is important when it comes to posting content on social media and marketing your business that way.

You want to make sure that people are aware of you and that they don’t forget your business.

If your posting is inconsistent or goes through long barren spells, people will stop taking interest.

That’s why it makes sense to create a consistent posting schedule, which you can easily do so with a content calendar in an Excel sheet.

Collaboration

It can also be a good idea to collaborate with influencers who operate in the same space as you.

Your business doesn’t need to be an island when it comes to marketing its services on social media.

You can often achieve much more and much further reach when teaming up with other people.

Automation and Scheduling

From a logistical point of view, you might also want to think about how your approach to social media marketing might be made easier.

There are lots of social media automation tools that will help you with that, so be sure to check them out.

There are hundreds of scheduling tools that’ll make your life much easier, and they’ll ensure that the consistency we discussed above doesn’t fall by the wayside.

Are you looking to grow the social media presence of your ABA therapy business? Let us know below!


ABA Therapy Claims Billing

ABA Therapy Billing Services From Rethink

ABA therapy billing services are now available to all Rethink Behavioral Health customers!

Prior to our billing services, Rethink customers only had the option of self-billing solutions. We have listened to our customers to fill a gap when it comes to billing for your ABA therapy services. 

Big or small, our ABA therapy billing services are built to scale

We believe that ABA practitioners should focus on providing care, not spending time reviewing payor contracts or following up on payments. While our ABA data collection tools, RBT training modules, scheduling and billing software improve your operations, billing departments may lag behind. A common reason billing becomes a burden due to external forces is when payor requirements are updated, and you get notified when you receive denials.  

You may have lots of questions, so we’ve listed some of the common concerns and thoughts our clients have below. Review them for help determining whether or not our services are right for your clinic.

Do you currently have an internal biller? 

If you answered yes, the next question you should ask yourself is “Does your current biller have the capacity to handle more work?” If you answered no to either one of these questions, then our solutions are a great fit for your organization.

Do you struggle in keeping up with payor requirements?

If you answered yes, then our billing solutions are definitely a great fit for you. Furthermore, if you are looking to diversify your payor mix in order to increase your clientele base, our team will help onboard your company with the new payors. Please keep in mind, we cannot negotiate contracts on your behalf as we are an extension of your team not a representative of your organization.

Are you looking to improve your cash flow?

While this is a silly question as most people will say, “Yes!”, one of the biggest benefits our customers see when they use our billing services is that we may help improve cash flow.  

Here's how...

We bill on a weekly basis and post payments once a week. In addition, our team reviews all denials and rejections. During our review, we analyze the reason behind the denials and we will address them with you to create improvements to reduce them. 

Is your billing department holding you back from scaling your business?

Customers that use our practice management solutions are able to scale their business without the worry of technology failing them. The benefit of technology is that it can scale as fast as you can hire and train new talent. Billing departments are vulnerable to scaling issues as it takes time to find the right resource. When you leverage our billing services, you can virtually scale your business as fast as you'd like without the worry of being backlogged with billing responsibilities (how awesome!? 🙌).

Do you want to ask somebody questions about billing or how to improve your process?

As an ABA therapy business owner, trying to keep up with client demands, insurance requirements, staffing efforts and other administrative burdens are not easy. Let alone, trying to create strategies around billing improvements. When you use Rethink’s billing services, you will have your own billing specialist will provide you transparent billing reports. Your billing specialist is your dedicated resource, they are there to help you grow and answer any questions you may have. 

For example, if our billing specialist notices is an increase in denials, they will start at the review of the data that is being collected by your team. If they notice inconsistencies in the data that are being collected they will notify you and provide you with guidance on how to improve. 

How much does this cost?

Our cost structure is aligned to the size of your organization and the volume of insurance claims. We would be happy to schedule a call to discuss options with you! To schedule a call with us click this link.


doctor in scrubs working at their desk

Best Practices for Determining Medical Necessity in Autism/ABA Treatment (Video)

This article is based on our recent webinar, Entrepreneurship in ABA: Best Practices for Determining Medical Necessity in Autism/ABA Treatment - Part 3, presented by Dr. Diana Davis-Wilson, DBH, LBA, BCBA.

Dr. Davis-Wilson is a licensed behavior analyst, with several years of experience providing consultation and training to families, school districts, and organizational personnel nationwide.

She holds a Doctorate of Behavior Health with an emphasis on integrated health care management and is currently the Chief Executive Advisor for Aspen Behavioral Consulting.

On-Demand replay of our webinar

If you are interested in learning more about how to break into, succeed, or grow as an ABA provider, you can sign up for our monthly webinar series, Entrepreneurship in ABA.

Medical necessity is a contractual concept related to healthcare coverage and activities that must be justified as reasonable, necessary, and appropriate, based on evidence-based standards of care.

The majority of health care contracts often include agreements which declare that a plan will provide coverage only for services that are thought to be reasonable and necessary.

Determining this will be up to the discretion of health plans, and in accordance with applicable law.

But how do we determine medical necessity in Autism and or ABA treatment?

Having reviewed samples of treatment plans given by health providers from across the nation, the most obvious and glaring concern is often consistency in documentation and in justification of medical necessity.

Also of notable interest is that many record reviews not only have inconsistency across certain regions of the nation or certain providers but also demonstrates inconsistencies across the documentation within the individual work of the behavior analysts that authored the plans.

What would be appropriate for medical necessity justification?

When consistency and documentation is among the major hindrances, what would it look like for health plans?

How hard would this be from an administrative perspective or a cost-effectiveness analysis?

Perhaps, a tool designed to bridge the language barriers between the clinician and the health plan could present some sort of consistency or standardization in the treatment planning process and assist clinicians in crafting medical necessity justification.

This way, all parties are speaking the same language.

Advancing The Medical Necessity of ABA

In order to continue the necessary conversations related to the medical necessity of autism treatment, the development of a medical necessity review tool may lend guidance for clinicians toward consistency in considerations of medical necessity justification.

In addition to serving as a training and quality assurance tool, the tool may also highlight the limitations pertaining to the research gaps and with that, empower and encourage others to develop research that can continue to advance the medical necessity justification of ABA treatment across a wide range of populations.

While setting a standard based on research for a specific hour amount (i.e. 22 hours for one client, 18 hours for another) may be ideal, it is unlikely that we are ever going to have that level of precision for reasons that would go against our own science.

In essence, we are always going to have to be able to calibrate our clinical decisions as necessary depending on the conditions that are going on in the environment.

We have to be able to make rapid changes based on frequent data analysis.

In fact, our own research method design allows for us to do just that which also makes dosage ranges a more realistic expectation due to the ability for synthesized research to provide clinical rationale anchors.

All the while, it is imperative to keep in mind with medical necessity is that there's not just one perspective to ABA in autism treatment and that in order for us to most effectively advocate both in public policy and then on a smaller level for individual plans with individual treatment plans with the health plan is that we really have to understand the patient and health plan perspective.

Additionally, the guidance of the tool would intend to demonstrate the limitations and best available evidence.

For example, if there is a discrepancy between the clinician’s recommendation and what the tool is saying, it does not mean that the clinician’s recommendation is wrong.

Rather, it is a suggestion that the research support base to support the clinician’s recommendation may be, different or limited, or may even need additional justification for that particular individualized case.

In other words, the best available evidence may be more difficult to define.

Therefore, treatment planning may need more precision.

Purpose of the Tool

The main advocacy of creating a tool for guiding the determination of medical necessity for ABA treatment is to address complex language barriers amongst key stakeholders and organizing various perspectives.

This will also encompass the following:

Education - Integrate the research in a fashion that educates those that provide support for the study and assist in a decision-making process for and articulated by clinicians.
Consistency - Provide documentation standardization and considerations for clinical report writing.
Training - Decision path tool for future clinicians.
Research - To shed light on research efforts that need to be established or strengthened – i.e. populations, age, diagnosis, etc.

However, this tool is not intended to replace the required clinical calibration necessary for individualized treatment planning.

Variations in the tool guidance is intended to demonstrate limitations in “best available evidence” and help establish direction in our advocacy efforts.

This is also not to guide funder or legal mandates on dosage or utilization requirements.

Key Features

• Produces a suggested dosage range or guideline based on best supporting synthesized evidence
• Provides a summary of the treatment plan components
• Provides a quality management training opportunity for supervisors or organization


teacher sitting with boy looking at a globe

10 Things You Should Know Before Starting an ABA Practice

This article is based on our recent webinar, Entrepreneurship in ABA: Top 10 Things I Wish I Knew Before Starting an ABA Practice, presented by Molly OlaMolly Ola Pinney, Founder/CEO of Global Autism Project Pinney, Founder/CEO of Global Autism Project.

If you are interested in learning more about how to break into, succeed, or grow as an ABA provider, you can sign up for our monthly webinar series, Entrepreneurship in ABA.

Starting a new Applied Behavioral Analysis (ABA) practice can be an exciting endeavor.

However, it can be also challenging if you don’t know where to start or how to compete against other practices that are already up and running.

Most practitioners undoubtedly start out with the idea to help others, but the reality is that many business owners fail for reasons including their inability to develop business know-how, a strong financial model, and an adequate sustainability plan.

To succeed in this emerging industry, you must learn it to understand the business side of your practice just as well as the clinical side.

The different facets can be overwhelming if you’re not already familiar, which is why we thought this would be a helpful topic to discuss.

In our recent webinar Entrepreneurship in ABA: Top 10 Things I Wish I Knew Before Starting an ABA Practice, Ola Pinney shares lessons from her own experiences and offers insight into the top things every ABA provider should consider to protect the sustainability and scalability of their business.

“Our organization has spent over a decade training businesses providing services across the globe, and I can’t wait to finally share what we’ve learned with you!” – Molly Ola Pinney

Here are a few tips to take away:

1.) Have Focus In Your Business

You should have a really compelling reason for switching gears in your practice.

A decision-making matrix can help you look at the different things you should focus on like time, costs and staff buy-in.

You should also be mindful of your messaging, marketing efforts and strategic efforts to support your bottom line.

2.) Learn More About The Numbers In Your Business

Even if you have an accountant, it is important that you understand cash flow and can plan for the future.

Some business owners tend to make a budget at the beginning of the year and then randomly check it throughout the year.

A regular budget analysis and plan for cash flow will help you note how money is coming in and going out so that you scale and spend appropriately.

Investments should also have a return.

3.) Develop A Crystal Clear Mission

The way that your business is going to attract people is by helping others understand and support your mission.

Ask yourself if you know where you’re headed and how you’ll get there.

According to Ola Pinney, “The how doesn’t matter nearly as much as the when, where and why.” When you’ve figured out your mission, you’ll want to figure out your why.

If you don’t yet have a mission, sit down with your team and write one down.

Then figure out your verticals and your people.

4.) Make Good Staffing Choices

Having a strong vision or mission will attract people who are there because they want to be.

You need specific expectations, guidelines and go-to policies.

You should leave no stone unturned when hiring, which may include creating an employee handbook (if you don’t already have one) and running guidelines and policies by your lawyer.

Think about the culture of your organization and what’s important to you and the people who work with you.

Weekly reports and regular meetings are amazing tools you can use once you have the right team.

You should also have a clear disciplinary process in place and never forget to hire slow and fire fast.

5.) Make Sure You Have A Strong Digital Presence

Does your company show up on multiple platforms?

Are you using social media platforms and ads appropriately?

Remember that your image should match your voice, your people should see themselves in your practice’s page and your visual identity should be clear, simple and inspiring.

Remember that you are connected to your company, so your personal image matters too.

6.) Determine Whether Your Company Is Scalable

In order to make your business scalable, you need strong processes.

Documenting processes allow you to plug in to them later and keep everything in one place so everyone knows where to go.

You should also think about your team and who you need on your team to move forward.

7.) Time Management Is Key

Even if you don’t think you have enough hours in the day, you do.

There are also enough hours in the day to take care of your body, mind and spirit.

“A good way to manage your time is to block and tackle,” says Ola Pinney.

Think about repetitive tasks and ways to leverage your time.

You should also delegate more tasks to others who can perform them.

8.) Change Your Mindset

In order to get a handle on the things you’d like to do, you need to change your time.

Try on the idea that you are the strong leader of your business and then figure out if you’re the roadblock to your own success.

9.) Be Consistent With Your Marketing

“One of the best ways to get the word out about what you do, is by talking about what you do,” says Ola Pinney.

Effective marketing requires a commitment to growth and a voice that people trust and want to hear more from.

Listening to and implementing best practices also help to make your marketing efforts more sustainable.

10.) Go To The Source

There is a lot that you can learn from others, including competitors/colleagues within the ABA field.

Make it a point to network and have a casual conversation.

These are just a few tips of the many things you should keep in mind as an ABA provider.

Another tip would be to have a practice management platform in place to streamline your processes and promote scalability while still ensuring client success.

Our one-stop-shop platform offers Billing services, Clinical tools, and Practice Management tools along with RBT Training, VB-MAPP licenses, and more than 1500 resources/materials as curriculum pieces.

Schedule a demo today at your convenience!


little boy on a playground crying

Liability Insurance Basics & Current Claim Trends in ABA Therapy

This piece is based on our recent webinar presented by Daniel Law, ARM, CRIS and President of Liberty San Jose of The Liberty Company Insurance Brokers.

You can sign up for the monthly webinar series, Entrepreneurship in ABA, mailing list here.

One of the most important business principles is to have an effective liability insurance policy in place to not only protect your business, but also yourself.

Insurance may be required for certain transactions and are usually a pre-requisite for the following:

  • During the process of obtaining funds
  • When applying in a school district/Regional center
  • From Easter Seals/BHPN
  • When trying to lease an apartment, a landlord may ask insurance from you

On the other hand, in order to be eligible for insurance, one must know the following:

  • Limits and type of coverage is within the range $1m-$3m
  • Indemnification
  • Additional insurance
  • Waiver of subrogation

ABA providers face unique risks such as:

  • Inherent Risks with Autism
  • Professional Exposure
  • Dangers to Employees
  • In-Home, School-Based, Clinic
  • Hiring and Retention
  • Regulation (Licensing, Funding Source, Authorizer)

For ABA therapy, the liability coverages are as follows:

Professional Liability

This is covered by a wide range of aspects such as in professional services fees incurred, a wrongful act by an employee or even for some circumstances the government mandates that or from regulatory standards.

They may be liable as well to those who are additionally insured, who are already insured or those who have a waiver of subrogation.

General Liability

This covers bodily injury, property damage, personal injury and even advertising injury.

The coverage may be divided into 3rd party coverage, the number of occurrences, limits and deductibles.

The liability will also differ when there is additional insurance, has waiver of subrogation and to those with common exclusion.

Abuse/Molestation

This item covers the vicarious liability, exclusions, and limits with the first item being the most concentrated one.

Vicarious liability will be in effect if the person being insured is known, there is an innocent party defense, and what items will be/should be covered.

Automobile Liability

This item covers the hired automotive, non-owned automotive liability, and physical damage liability.

Physical damage is determined by which a person involved is insured/not insured, the application/coverage of the liability, and the determining of who can be able to drive and who cannot.

Cyber Liability

This is a liability policy that covers a data breach or compromised personal information of a client.

It can be covered by the consideration of HIPAA concerns, how much the coverage is and other options.

In this manner, the regulatory trends are appropriate to be considered.

The WCIRB – NCCI should be taken into account regarding Workers' Compensation changes while for funding sources, the increased requirements and increased scrutiny should be considered as well.

Lastly, for regulatory trends, it is important that accreditation, state licensing, and inspections are to be considered as well.

In the aspect of claim trends, the following should have attention:

Independent contractors

RBT cannot be an IC or else it would be Mis-classification.

In the event the IC wants to have the medical bills paid, the action over claims must be understood. In terms of work comp issues, one must consider looking into those who are not paying a premium.

Cyber/Data Breach

In this type of claim, several items should be assumed to be claimed:

  • HIPAA Allegations/Violations
  • The costs involved incurred by the breach
  • If the attacker claims for ransom
  • The liability on who owns the records

These are some of the items that may be claimed in the event of a Cyber/Data Breach.

According to Bloomberg, health data breaches can cost more than $400 per patient and have an average claim trend of ~3m per year.

This is due to the fact that Phishing and social engineering have been the major drivers of cyber events.

Employment Practices Liability

Possible claim items include misclassification, wrongful termination of an employee and failure to pay appropriate wages and incidentals such as overtime, drive-time, and breaks.

Workers’ Compensation

This claim item includes worker vs. contractor claim disputes, classification systems, and even the origins/causes of the injuries.

Injury to Children

This is one of the most sensitive items mainly due to the fact that children are involved in this situation.

Claims could come from the clinical setting, community outings (i.e. injuries from accidents on the event), and even child abuse/molestation.

Indemnity and Defense

This claim item includes the item about contracts (i.e. a school was being sued by its employee after being injured), how the claim works and what are the items seen in certain situations.

Rethink Behavioral Health provides an intuitive and comprehensive solution to scale your ABA business and ensure client success.

Our one-stop-shop platform is HIPAA compliant and offers both Clinical and Practice Management tools along with RBT Training, VB-MAPP licenses, and more than 1500 resources/materials as curriculum pieces.

Schedule a demo today at your convenience!


a diverse group meeting in a conference room

10 Tips for Motivating and Retaining Staff

This piece is based on our recent webinar presented by Erin Mayberry, MS, BCBA, LBA and current Professional Services Consultant for Rethink Behavioral Health.

You can sign up for the monthly webinar series, Entrepreneurship in ABA, mailing list here.

Have you ever felt burnout at some point in your employment?

In one way or another, each one of us has experienced a certain type of stress that was induced at work or because of work.

In Applied Behavior Analysis (ABA), staff burnout is an essential item that needs to be monitored as it can lead to high turnover and disrupt consumer care.

On average, a behavioral therapist costs an estimated $5,000 upon leaving the company, not including the money spent on recruiting, onboarding, training, etc.

Let’s find out more about the most common work stressors:

According to Schulz, Greenley & Brown (first published in 1995)1, the most common stressors are the following:

  • Organizational Context (size of the company, task ownership, staff compensation, leadership style)
  • Work Satisfaction (nature of work, workload, work routine)
  • Client Severity (mental illness, psychiatric tendencies, developmental disabilities)
  • Work Environment (lack of job clarity, difference in company/organizational goals)
  • Staff Characteristics (Role tenure, age, staff education)
  • Organization/Management Process (Organization culture, influences on leadership, lack of social support)

In addition, common work stressors according to Waters (1999)2 are as follows:

  • Relationships with Coworkers and Supervisors (unsupportive to collaborations)
  • Effort vs Reward (felt undervalued, overloaded with work)
  • Lack of Influence on Decision Making and Outcomes (one’s opinion is not valued or is overlooked)

A literature review of burnout research was conducted by Bakker & Costa3 in 2014 which focuses on loss cycles and loss-gain cycles of chronic burnout.

In the research, the loss cycle consists of the following:

  • Job demands are associated with physiological and psychological costs. This includes fatigue/loss of sleep and increased heart rate which may then lead to physical and mental exhaustion
  • Daily exhaustion has the tendency to impact one’s work performance, which may then lead to employee ineffectiveness

In the case of the loss-gain cycle, the following are considered:

  • Encouragement of personal growth by providing better work opportunities
  • Availability of job resources and versatility

So how should we mitigate employees experiencing staff burnout?

Here are some of the most effective ways to prevent staff from experiencing burnout in the workplace:

Set Clear Expectations

As leaders, being transparent is a key trait in gaining trust from your staff. The same is true with setting expectations for them.

You have to ensure that expectations are clear and defined in measurable/observable terms.

If there are expectations that cannot be met for some reason, there should be a contingency plan in place.

Provide Effective Training

Onboarding new staff is time-consuming and often expensive.

With that being said, it is most ideal to train them properly rather than being thrown into a new role with no formal training at all.

A structured training method such as behavioral skills training or a peer training program can truly help in achieving positive, lasting results.

Not just onboarding, professional development can increase employee morale, performance, and treatment.

Provide Frequent Feedback

Let’s face it – an employee will not know what he/she is doing is right if no one tells him/her about it.

Make sure to provide feedback to your staff regarding their performance.

Balance corrective feedback with positive feedback, and try to only provide positive feedback occasionally.

Utilize Peers

The best way to encourage staff, specifically if they are performing well, is by telling them that they are doing well, which doesn’t always have to come from leadership.

Colleagues/peers can also help you provide feedback to their coworkers.

This can be achieved through shout outs, peer training and observation, and feedback in the moment.

Establish Individualized Goals

Personalized goals are effective because staff have more buy-in and accountability when they are able to help create the goals they will be working toward.

Every staff brings a unique set of skills and characteristics to the job, so it is important to recognize that each staff person may need support in different aspects of their job performance.

Use Preference Assessments

Not everyone likes the same thing, thus diversity should always be one of the top priorities as a leader.

Staff bonuses may not be too enticing for some people, as they prefer more time off rather than more money.

In this case, it is always a must to practice avoiding assumptions, but rather be open to opinions of the whole staff.

Provide Incentives for Performance

Once you know your staff’s preferences, you may use them to provide performance incentives when they achieve the goal that has been set for them.

This may include money, additional paid time off, or anything else the employee may value.

Establish a Supportive Organizational Structure

If there is a supportive organizational structure, staff are more likely to work together.

A supportive organizational structure encourages open communication, respect across all levels of employment, and establishes clear goals and visions.

Encourage Self-Monitoring

By letting your staff measure their own performance, you have the opportunity to encourage staff to create goals for themselves and personally evaluate their progress toward that goal.

This is a great way for staff to have immediate feedback when leadership isn’t always available to provide feedback in the moment.

Model the Behavior You Want to Increase

The mentality “Do as I say, not as I do” is ineffective. The more effective way to lead is by example. Model behaviors you want staff to imitate.

You can also encourage staff to be models for their peers. Some staff learn best by observing a competent colleague demonstrate a skill first.

By including some or all of these strategies in the workplace, you can reduce the stress and burnout staff may feel on the job.

Not only will staff be more supported, their overall job performance may improve as well which can lead to increased client happiness.

Two simple, low-cost methods to get you started (or keep you on the right track) is providing professional development such as Registered Behavior Technician (RBT) training and equipping your team with the necessary, mobile-friendly tools to make their on-the-go job easier.


Rethink Behavioral Health provides an intuitive and comprehensive solution to scale your ABA business and ensure client success.

Our one-stop-shop platform offers both Clinical and Practice Management tools along with RBT Training, VB-MAPP licenses, and more than 1500 resources/materials as curriculum pieces.

Schedule a demo today at your convenience!

References:

  1. Schulz, R., Greenley, J.R., & Brown, R. (1995). Organization, management, and client effects on staff burnout. Journal of Health and Social Behavior, 34, 333-345
  2. Waters, J.E. (1999). The impact of work resources on job stress among correctional treatment staff. Journal of Addictions and Offender Counseling, 20, 26-34
  3. Bakker, A.B. & Costa, P.L. (2014). Chronic job burnout and daily functioning: a theoretical analysis. Burnout Research (1), 112-119.

Businesspeople looking at paper charts and a macbook

New Category 1 CPT Codes for Applied Behavior Analysis (ABA) Services

rethink-vbmapp-promo Category 1 CPT Codes

Anthony Porcelli, Manager of Billing Services for Rethink Behavioral Health, had the pleasure of attending Dr. Wayne Fisher’s workshop on the new Category 1 CPT Codes for ABA Services, which will be effective January 1, 2019.

I split the workshop into 3 sections:

  1. Interpreting the new Category 1 CPT Codes
  2. Suggestions to help valuate the codes when negotiating rates with payers
  3. The work was undertaken to get the new Category 1 CPT Codes accepted by the American Medical Association (AMA)

The two great advantages I see with the new codes are that they are broken up into 15-minute units to allow for more efficient billing and the ongoing codes are no longer needed.

A quick crosswalk for the more commonly used codes is listed below and more detailed descriptions can be found here.

Old Category 3 CodeNew Category 1 Code
0359T97151
0360T – 0361T97152
0364T – 0365T97153
0368T – 0369T97155
0370T97156
0371T97157

A key talking point of the workshop involved valuating the codes when negotiating rates with payers.

When negotiating rates it is important to demonstrate to payers the amount of work that goes into each service.

For instance, when negotiating rates for a technician appointment (0364T – 0365T) providers should mention the training that is involved between the BCBA and the tech before the appointment, the work that goes on during the actual appointment, and the interpretation of data and session notes created afterward.

To do this, Dr. Fisher suggested that providers consider each CPT Code in 3 parts:

  • Pre-Service
  • Intra-Service
  • Post-Service

Pre-Service includes everything that goes on before the appointment takes place such as training staff and writing protocols.

Intra-Service consists of the work that goes on during the actual appointment itself while Post-Service is the work that happens after a session is completed such as writing progress notes and reviewing data.

By doing this, the provider can adequately describe the full scope of work that goes into each appointment.

A further example is provided below for what goes into a Support/Technician Appointment:

0364T – 0365T

Pre-Service Work

  1. BCBA: Trains a technician to perform the service.
  2. RBT: Attends trainings with BCBA. Reviews patient medical records. Creates materials for sessions.

Intra-Service Work

  1. RBT: Works with client based on protocols created by BCBA.

Post-Service

  1. RBT: Writes session notes. Communicates with BCBA as needed about sessions.
  2. BCBA: Reviews/Approves session notes. Interprets data. Updates treatment plan.

Next Steps

The last piece of the workshop involved discussion on the next steps that Dr. Fisher and his group would be working on involving the new Category 1 CPT Codes.

The first order of business for the group is releasing a “Tool Kit” for providers to help valuate their services when getting ready to negotiate with payers.

Dr. Fisher and his team will also work with the AMA to address the issue of billing for both the RBT and BCBA during overlapping service times.

He believes providers should be able to bill for both services concurrently because the responsibilities of each professional during the mutual session are different.

In Summary

In summation, I believe the new codes will positively affect the ABA world and simplify the billing process.

Since the ongoing codes have been eliminated, there will be less line errors during billing, leading to faster payments and less back-and-forth interaction with the insurance companies so that providers can spend more time with their clients.

Also, since the new codes have been assigned category 1 status, I hope that payers will be more uniform with their interpretations of their use which will also make for improved efficiency in billing.

rethink-promo- Category 1 CPT Codes

From scheduling the appointment to providing resources for treatment and tracking progress to getting paid - Rethink Behavioral Health will completely support you.

No more juggling systems.

Full Features

Our complete platform features:

  • Billing & Full Revenue Cycle Management (RCM) features electronic claims submission & remittances, eligibility verification, patient statements and payments portal, financial reporting, and more!
  • Staff Training & Resources on-demand, self-paced RBT Training and access to thousands of printable resources.
  • Clinical Programming & Data Collection spend less time on administrative tasks with robust tools for assessment, treatment planning, data collection and progress reporting.
  • Advanced Scheduling Tool Easy appointment set up, view multiple staff & client schedules at once, seamless controls prevent coding and scheduling errors, capture session notes and parent signatures.

Schedule a demo today at your convenience!


filing cabinets with rows of patient medical records

Translating Medical Necessity Criteria (MNC) for ABA Providers Working with Health Plans – Part 2

The live webinar for part 3 of our Medical Necessity Criteria Series will take place on Thursday, June 20th, 2019 at 1:00 PM ET.

We will also be unveiling our brand new, industry-first Medical Necessity Criteria Assessment Tool for ABA Services!

Be one of the first to see it in action by attending the webinar.

Register now!


This piece is based on our recent webinar presented by Dr. Diana Davis-Wilson, DBH, LBA, BCBA, who is a licensed behavior analyst, with several years of experience providing consultation and training to families, school districts, and organizational personnel nationwide.

She holds a Doctorate of Behavior Health with an emphasis on integrated health care management and is currently the Chief Executive Advisor for Aspen Behavioral Consulting.

Part one can be found here.

You can sign up for the monthly webinar series, Entrepreneurship in ABAmailing list here.

As clinicians, Applied Behavior Analysis (ABA) providers seek to improve the lives of their patients by offering treatments that are both beneficial and medically necessary.

Factors To ConsiderMagnifying Glass with words

However, the needs of patients are just one of the many factors that need to be considered in health care.

There are also the needs of health plans to consider.

This is usually what ABA providers refer to as the preauthorization process where providers create treatment plans, follow standards, and send their treatment plans to health plans.

Throughout this process, health plans analyze these treatment plans to determine whether they satisfy medical necessity criteria.

Health plans are also obligated to consider medical necessity as a legal concept that follows and adheres to specific guidelines and coverage policies.

Some clinicians don’t factor this perspective into their treatment plans and as a result, struggle to comprehend what they should deliver to health plans.

In a recent Rethink Behavioral Health webinar, Dr. Diana Davis-Wilson, the Chief Executive Advisor for Aspen Behavioral Consulting in Arizona, outlined a few ways ABA providers can navigate the world of health care and “learn the language of health plans”.

The First Step

The first step, she says, is to understand how medical necessity is viewed by clinicians, health plans, and legal entities.

“When it’s unclear as to what medical necessity is or when we don’t have the data to support the typical avenues for developing medical necessity, it becomes challenging for us to present our cases to health plans,” says Davis-Wilson

Health plans are usually responsible for large populations and must make their decisions based on the interests of the majority.

This is often unique to ABA providers, who commonly look at priorities and patient care from an individual scope.

When an individual purchases a health plan, the policies are driven by many things; one of which is the population itself and the majority.

Therefore, a health plan’s job is to develop guidelines and coverage policies specific to a variety of different components outside of the individual lens.

Additional Considerations

Considerations to coverage policies include an intensive review of available documentation pertaining to the following indicators:

  • Disease burden
  • Public or provider interest
  • Controversy
  • Variation in care
  • Cost
  • Quality
  • Effectiveness of research
  • Potential impact to the entire population

To the untrained ABA provider’s eye, these factors may not have a significant impact.

But from the perspective of a health plan, decreasing disease burden, reducing long-term costs and improving the quality of care and the effectiveness of research is a benefit to a majority of individuals with health plans, not just singular patients.

When ABA providers fail to realize this, medical necessity reviews can become problematic for them and health plans.

ABA providers can also experience a breakdown in communication with health plans that must satisfy the needs for a majority within populations they serve.

Primary Goals

But at the very heart of the matter, health care will always have three main goals.

“This is better known as the triple aim”, says Davis-Wilson, and provides three objectives:

  • To improve patient care and the patient experience
  • To improve the health of populations by aiming for continuous improvement to the quality of care
  • To reduce the future per capita cost of health care by allowing individuals to obtain preventive services and care prior to the presence or discovery of certain illnesses and diseases

So where does medical necessity come in, and how can we translate it into a language that we understand?

According to Davis-Wilson, medical necessity means that the services an ABA provider carries out is for the purpose of evaluating, diagnosing or treating an illness, injury, disease or its symptoms.

It is expected to be in accordance with the accepted standards of practice and should be clinically appropriate, efficient and cost-effective.

Measuring progress is an essential component as to whether treatment is considered efficient and cost-effective. Most plans seek to reduce the duplication of services and prevent contradictions that may be costly.

Health plans are also committed to monitoring client progress individually and as a whole for populations, thus moving them closer to their goal of reducing the future per capita cost of health care.

In essence, the more ABA providers learn to think of the whole as a sum of the individual parts, the better they will be equipped to create treatment plans and satisfy criteria in a way that health plans can understand.

Legal Components

The legal aspect of what health plans require is also very rarely discussed but plays an essential role in how health plans view medical necessity.

Many health care contracts include agreements that state that a plan will provide coverage only for services that are deemed reasonable and necessary, which is up to the discretion of health plans.

This also means that the progress an individual makes over the course of a treatment plan is more likely to be approved by health plans when it’s meaningful to overall outcomes for majorities within populations and supported by research.

When a treatment is supported by research, health plans can justify compensation for services provided and satisfy reductions and improvements to indicators such as disease burden, cost, quality, effectiveness of research and the potential impact on majorities within populations.

Yet, these are just some of the many ways ABA providers can become experts at decoding medical necessity criteria and documentation for health plans.

Learning to speak the language requires careful attention to detail and a more holistic perspective of health care in general.

Rethink Behavioral Health provides an intuitive and comprehensive solution to scale your ABA business and ensure client success.

Our one-stop-shop platform offers both Clinical and Practice Management tools along with RBT Training, VB-MAPP licenses, and more than 1500 resources/materials as curriculum pieces.

Schedule a demo today at your convenience!