ABA Therapy

ABA Therapy Billing Cash Flow

Your RBTs and BCBAs get paid every week, but Medicaid managed care takes 45 to 90 days to pay the 97153 claims behind that payroll.

The ABA therapy billing problem, solved.

ABA payers, days to pay

Centene (Medicaid MCO)14% denied62 days
Molina (Medicaid MCO)12% denied58 days
State Medicaid10% denied54 days

The squeeze

Weekly

payroll

RBT and BCBA payroll runs every week, while Medicaid managed care pays 45 to 90 days later.

The codes Copay purchases.

Each ABA code is priced individually at the service line and funded the next business day.

97153

Adaptive behavior treatment by protocol, administered by technician, each 15 minutes

Copay purchases this
97155

Adaptive behavior treatment with protocol modification, each 15 minutes

Copay purchases this
97156

Family adaptive behavior treatment guidance, each 15 minutes

Copay purchases this
97158

Group adaptive behavior treatment with protocol modification, each 15 minutes

Copay purchases this
How it works

How Copay works for ABA therapy.

Your existing EHR

No change

Claim 97153

Centene · $58.20

Drafting

Submit claims as you always have

Your billing team submits claims exactly as they do today. Nothing changes except when you get paid.

CN

Centene

Medicaid eligibility check

Copay
Verifying payer

We verify in the background

Copay confirms payer and claim data automatically, with no calls from your team.

See the full process

Built for the ABA payroll cycle.

Weekly payroll

Make weekly payroll without waiting on Medicaid.

Copay funds your eligible claims the next business day, so the cash for payroll is there every week.

Copay

Funded by Copay

Every week
W1
W2
W3
W4
W5
W6

Payroll covered every week, even while the Medicaid claims behind it are still adjudicating.

Non-recourse

Denied

Non-recourse means a denied eligible claim is Copay's loss, not yours.

No personal guarantee

Your home and personal credit are never on the line.

Common questions

ABA billing, answered.

No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible ABA claims outright and deposits funds the next business day, with no debt and no repayment schedule.

ABA services are billed heavily through Medicaid managed care, so Copay purchases eligible claims billed to state Medicaid plans and managed care organizations such as Centene and Molina, as well as commercial plans including UnitedHealthcare, Aetna, and Cigna.

ABA practices run payroll for RBTs and BCBAs weekly, while Medicaid managed care can take 45 to 90 days to pay 97153 and 97155 claims. Copay purchases those eligible claims and funds them the next business day, so weekly payroll is covered without waiting on the Medicaid cycle.

Non-recourse means a denied eligible claim is Copay's loss, not yours. If an eligible purchased ABA claim is denied or underpaid, Copay absorbs the loss with no clawbacks against your practice.

How Copay works for ABA therapy practices

From submitted claim to funded account.

While insurance takes 30 to 90 days, Copay moves in one.

Step 01 · Submit

You submit your claims as normal

Nothing changes about how your billing team works.

Claim #18473

DOS 02/04/24

CPT code97153

Adaptive behavior treatment by protocol, administered by technician, each 15 minutes

PayerCentene
Billed$58.20

Step 02 · Verify & Price

We verify and price in real time

Copay checks payor history and prices the claim at the CPT level.

Underwriting in progress

Step 03 · Approved

Advance approved

Capital is approved and scheduled for next business day deposit.

Advance Approved

$3,200

Net advance

Funds wired to your account, next business day

Step 04 · Funded

Capital in your account

While the payor takes 30 to 90 days, you already have your capital.

Your account

$0

Available balance

Copay reconciles automatically when the payor pays. You do nothing.

Cover ABA payroll without waiting on Medicaid.

Copay purchases your eligible ABA claims and pays the next business day. No loans, no personal guarantee, no workflow change.