Six services. One specialized team.

Each stands alone or bundles with the others. Jump to the one you need — or read the full picture below.

Jump to a service

Credentialing

We handle the entire credentialing lifecycle for your providers — new credentialing for first-time payer enrollments, recredentialing when the BACB or payer cycle requires it (every 3 years for most payers), and ongoing maintenance of every provider’s CAQH attestation.

What’s included:

• CAQH profile setup and quarterly attestation
• NPI registration (individual + group as needed)
• Commercial payer applications (Aetna, Cigna, UnitedHealthcare, Anthem, Humana, regional Blues)
• Medicaid and Medicaid MCO enrollment in every state where your practice operates
• TRICARE and other government program enrollment when applicable
• Follow-up cadence on pending applications (we don’t wait for the payer to update us — we call them)
• Document management and renewal alerts before credentials lapse

Best for: New BCBA owners credentialing for the first time, growing practices adding new providers, multi-state expansions, recredentialing cycles.

Go deeper: the complete credentialing roadmap · CAQH setup guide · credentialing with Cigna, UHC, and other commercial payers

Billing & RCM

ABA billing is its own discipline. CPT codes 97151–97158, RBT supervision documentation, prior authorization workflows, Medicaid MCO variability state-by-state, modifier rules that differ per payer — generic medical billers fumble it. We don’t.

What’s included:

• Daily claim submission with ABA-specific coding per the AMA adaptive behavior services code set — 97151 behavior identification assessment, 97153 technician-delivered treatment by protocol, 97155 BCBA-delivered treatment with protocol modification, 97156 family guidance, 97157 multiple-family group guidance, 97158 group treatment with protocol modification (plain-language breakdown here)
• Prior authorization tracking and renewal management
• Denial management and resubmission within payer-specific timely-filing windows
• Days-in-AR monitoring (industry benchmark: under 35 days for healthy ABA practices)
• Payer-specific clean-claim rate reporting
• Monthly reconciliation against your practice management system
• Year-end summary for tax and BHCOE/CASP accreditation reporting

Best for: Practices generating $500k+ in annual revenue, multi-payer practices, practices currently using a generalist medical biller, practices preparing for accreditation or audit.

Go deeper: the RCM metrics to track monthly · top ABA claim denial reasons and fixes · prior authorization by payer

Payer Contract Negotiation

If your payer rates haven’t been renegotiated in three or more years, you’re almost certainly leaving money on the table. We handle initial commercial contract negotiations, renegotiations after rate review periods, and Medicaid MCO contracting where state law permits negotiation.

What’s included:

• Market-rate benchmarking for your CPT mix and geography
• Initial contract negotiation with commercial payers
• Re-negotiation when rates haven’t moved in 2+ years
• Single-case agreement (SCA) negotiation for out-of-network situations
• Network adequacy advocacy in states with autism-mandate enforcement
• Contract review and red-flag identification (rate-floor language, audit clauses, termination provisions)

Best for: Established practices with 2+ years of payer relationships, practices entering new markets, practices that suspect they’re underpaid relative to peers.

Go deeper: how to negotiate ABA payer contracts · winning single-case agreements

Practice Startup

The hardest part of opening a new ABA practice isn’t clinical. It’s the 90-180 day window between deciding to open and getting credentialed enough to bill. We compress that window by parallel-tracking everything that can be parallel-tracked.

What’s included:

• Entity formation guidance (LLC, PLLC, S-Corp considerations for ABA)
• NPI and tax ID setup
• BACB practice registration
• Initial CAQH and payer enrollment (start day-1 of decision, not day-1 of doors-open)
• Billing infrastructure setup (clearinghouse, claim submission workflow, EOB processing)
• Operational consultation (RBT supervision ratios, documentation standards, audit preparation)
• BHCOE/CASP accreditation prep when relevant

Best for: BCBAs leaving an employed role to start their own practice, established practices expanding to a new state, anyone in the 6-month window before opening doors.

Go deeper: the startup credentialing roadmap · first-year cash flow planning · NPI Type 1 vs Type 2 for BCBA practices

Multi-State Expansion

Multi-state operations multiply credentialing complexity. Every state has different Medicaid MCO requirements, different commercial payer footprints, different licensing requirements, and different timely-filing rules. We handle that complexity so you don’t have to staff for it.

What’s included:

• State-by-state licensing strategy
• Per-state payer mix analysis and prioritization
• Parallel-tracked credentialing across all target states
• State-specific Medicaid MCO enrollment
• Compliance with state-specific autism mandate variations

Best for: Practices currently in one state planning to expand to a second or third, regional groups consolidating multi-state operations.

Go deeper: expanding your ABA practice to a second state · Medicaid MCO billing state by state

Website & Marketing

A generic medical-practice marketing agency can’t fill an ABA caseload. The buyer pool is small, specialized, and doesn’t respond to generalist marketing — parent referrals come from pediatricians, school districts, and BACB-credentialed peers. We build the website and run the marketing motion that actually puts your practice in front of those referrers.

What’s included:

• Practice website (HIPAA-conscious build, plain-language for parents, credentialing badges and intake form)
• SEO targeted at ABA-specific search (“ABA therapy near me,” “autism therapy [city],” insurance-mapped landing pages)
• Google Business Profile setup and review-acquisition workflow
• Pediatrician and school-district referral outreach (the actual referral sources that send you families)
• Insurance-network landing pages (parents searching “ABA that takes [their plan]”)
• Content for parents (intake explainer, insurance navigation, what-to-expect-from-an-assessment)
• Monthly performance reporting (organic search rankings, form fills, source attribution)

Best for: New practices building an initial caseload, established practices opening a second location, practices with steady credentialing-and-billing but flat assessment-schedule growth.

Major payers we work with

We work with every major commercial and government payer that covers ABA therapy. A sample of those we credential and bill with regularly:

Aetna · Anthem Blue Cross Blue Shield (multi-state) · Cigna · UnitedHealthcare / Optum · Humana · Magellan Healthcare · TRICARE · State Medicaid (all 50 states) · Medicaid Managed Care Organizations (Centene, Anthem, Molina, AmeriHealth, regional MCOs)

Don’t see yours? We probably still work with them. Most ABA-covering payers are on our roster — ask in your consultation.

Common questions