How to Prevent ABA Insurance Denials: Intake Process Fixes

Before your billing team ever touches a claim, you could already be on track for a denial — and it often starts with how you bring new clients into your ABA therapy practice.

We just hosted a roundtable inside the ABA Business Challenges Facebook group featuring four expert contributors who each work on a different part of the denial puzzle:

• MaKenzie Johns – Executive Clinical Advisor at Bloom International Ventures & Director of Operations at Arohana Support

• Jerome Chiu – Compliance Consultant & Founder at RadBx

• Elanor Neff – Clinical Documentation Expert & Founder of Clear Clinical Consulting

• Michael Gao – COO of Alpaca Health, specializing in RCM & Billing Systems

We’ll be releasing the full replay soon, but we wanted to share one of the most common — and most preventable — denial triggers they all pointed to: your client intake process.

🔍 Intake Mistakes That Trigger Downstream Denials

What Happens:

Many ABA providers accept new clients without a structured intake process. When that happens, basic steps are often missed — like capturing both sides of the insurance card, calling the correct payer line, confirming service coverage, and verifying benefit details. These small misses often snowball into major billing issues weeks later.

What the Experts Emphasized:

MaKenzie Johns highlighted how many new ABA owners aren’t fully prepared for that first payer call — especially if they haven’t set up a consistent intake format. She recommends starting with a standardized process and clear data collection from day one.

Jerome Chiu warned that calling a generic payer phone number (like one found on Google) is a major mistake. Those numbers often route you to departments with no contractual accountability for wait times — meaning you may never reach the right person. Always use the number on the back of the client’s card.

Elanor Neff pointed out that many diagnostic reports submitted at intake don’t meet payer requirements. Different insurers have specific expectations for who conducted the evaluation, how recent it is, and what tools were used. Intake teams need to understand what documentation is acceptable before submitting for pre-auth.

Michael Gao stressed the importance of communicating with families early and clearly. Many parents are unfamiliar with terms like “deductible” and “coinsurance,” and they’re often caught off guard when their financial responsibility changes. Intake is the best time to educate and prepare them — before billing issues arise.

🔑 Action Steps:

✔ Use a standardized verification of benefits (VoB) form for every client
✔ Always call the provider-specific phone number on the back of the insurance card
✔ Document the call: rep name, date, reference number, and notes on coverage and authorizations
✔ Confirm whether ABA is covered, if a pre-auth is required, and what documentation is needed
✔ Train intake staff to explain deductibles, out-of-pocket maximums, and what changes to expect in January

💡 According to industry research, over 70% of insurance denials are tied to intake and eligibility issues — not billing errors.

We’ll be sharing more takeaways from this live session soon, including what these experts had to say about treatment plan rejections, audit red flags, modifier issues, and documentation pitfalls.

But for now — if you’re working on tightening up your intake process, this is where to start.

👉 Let us know in the comments how you’re currently handling verification of benefits, and stay tuned for the full replay and Part 2 of the series.