Frequently Asked Questions

We’re an outsourced billing team for ABA, early intervention, speech, occupational therapy, pediatric, and mental health practices. We submit your claims, and when one comes back rejected, denied, or underpaid, we correct it, resubmit or appeal it, and find the root cause so it stops happening. We also track prior authorizations and units, post payments, and report back to you.

Six reasons agencies hand us their billing:

• Reliability. You get a staffed team, not a single biller. Your account has a named US point of contact, and coverage doesn’t stop when someone is out sick or on vacation.
• Speed. Onboarding takes days, not months. Rejections and denials are worked every day, ordered by filing deadline, so claims don’t time out in a queue.
• Effectiveness. Each returned claim goes down the right path the first time: replacement, void, new claim, or appeal. Then we fix the root cause so the same denial stops coming back.
• Security. Only our US-based staff touch your systems or identifiable data. Offshore staff and AI work on data with identifiers removed, and a BAA is signed before we start.
• Therapy focus. We bill practices that work like ABA: time-based codes, prior authorizations, unit caps, and state Medicaid quirks are our everyday work.
• Clear pricing. One monthly price based on claim volume, not provider count, and a monthly summary of what was denied, fixed, paid, and still open.

ABA and autism-services agencies, early intervention programs, speech-language and occupational therapy practices, pediatric clinics, and mental health group practices. We don’t price per provider, so the size of your roster doesn’t change what you pay. See all industries.

Book a call, sign the BAA, create individual logins for our team in your systems, share your recent denial and aging reports, and name a point of contact. Our getting started page lists every question we’ll ask, with a checklist you can fill in and print.

Most agencies are set up and submitting claims within 3 to 5 business days. We start with the open denials closest to their filing deadline.

The one you already use, whether that’s an ABA specific platform or a general practice management system or EHR. Nothing changes for your clinicians. If you’re not sure we’ve worked in yours, ask us on the call.

A corrected claim replaces or cancels a claim the payer already processed. We send a replacement (frequency code 7) when the original went through with an error, such as wrong units, a missing modifier, the wrong rendering provider, place of service, or dates. We send a void (frequency code 8) when it shouldn’t have been billed at all. Claims rejected by the clearinghouse never reached the payer, so those are fixed and sent as new claims. Denials for authorization or medical necessity usually need an appeal instead. We sort each one into the right path.

Every day. Rejections, denials, and underpayments are triaged as they come in, not saved for a month end batch, and a correction goes out as soon as the fix is checked. Corrected claim filing limits vary by payer and are often shorter than the original timely filing limit, so we work the closest deadlines first.

For each denial we look for why it happened: an authorization that ran out of units, a provider who isn’t set up correctly with the payer, a missing modifier, the wrong place of service. Then we fix it at the source, or tell you exactly what needs to change, so the same denial doesn’t keep coming back.

Yes. We track authorized units per code and date range, compare them against scheduled and billed sessions, and flag authorizations that are running low or about to expire so they can be renewed before claims start denying.

On the Business plan you get a monthly email summary with no client data in it: counts and dollar amounts for claims submitted, denied, corrected, paid, and still open, plus the top denial reasons and root causes we fixed. Claim level detail comes as an encrypted, password-protected ZIP file attached to the email. It doesn’t expire, and the password is shared with you separately, never in the same email. Enterprise clients get a web portal for reports and requests instead.

Yes. Credentialing a group of BCBAs or RBTs, or setting up a new payer, is project based work under an Enterprise agreement. On the Business plan, we flag enrollment problems we find in your denials so they can be fixed.

Commercial plans, Medicaid, managed Medicaid, and TRICARE, nationwide. ABA rules vary by payer and by state, so we bill to each payer’s version of them.

The adaptive behavior codes 97151 through 97158, plus 0362T and 0373T, with the modifiers and provider rules each payer requires. Some state Medicaid programs use their own codes and credential modifiers for ABA, and we bill to the rules of your state and plans.

Yes, as long as they’re still within the payer’s filing limits. We review your aging and denial reports, sort claims by deadline and dollar value, and work the ones closest to timing out first.

We’ll tell you which ones are. Sometimes an appeal with proof of timely filing can still work. If it can’t, we show you the claim and the reason, and you decide whether to write it off. We never adjust a balance without your approval.

Yes. We sign a BAA with every client before anyone on our team gets access, at no extra cost on every plan. Every vendor in our stack that can touch client data, including the AI tools we use, is under its own BAA.

Yes, sometimes. Most work happens inside your practice management system, clearinghouse, and payer portals, but some tasks need files like ERAs, aging reports, or authorization letters. When we download, we take only what the task needs, open it only on company managed laptops with encrypted drives and multi factor sign in, save it only to BAA covered storage, and delete it when the work is done. See our security page for details.

To triage denials and spot root cause patterns. We only use AI tools from vendors under a BAA, we remove identifiers wherever possible first, and a person reviews every correction, void, or appeal before it’s submitted. No client data is used to train AI models.

Ravenswood doesn’t hold its own SOC 2 report. The software we use comes from SOC 2 audited vendors. Once a BAA or NDA is signed, we share the full list of software we use and those vendors’ SOC 2 reports.

Yes. We carry professional liability, errors and omissions (E&O), and general liability insurance. Coverage amounts and certificates of insurance are available on request once an agreement is signed.

Your data belongs to you. We hand over the claim records, reports, and notes from our work, remove our logins from your systems, and return or delete any working files as our agreement specifies.

Two plans. Business is $999 a month with no setup fee, month to month, and includes 250 claim submissions and 50 denial resubmissions per month. Enterprise is custom. See the pricing page for a side by side comparison.

A claim submission is each claim we send to a payer for the first time. A denial resubmission is each rejected, denied, or underpaid claim we work and send back: a corrected claim, a void, a fixed resubmission, or an appeal. Finding the root cause is included.

You pay as you go: $4 for each extra claim submission and $25 for each extra denial resubmission. It shows up as a line on your monthly invoice. There’s no forced upgrade.

Because the work scales with claims, not headcount. An agency with many part time RBTs shouldn’t pay more just for having a bigger roster.

Not on Business. There’s no setup fee and it’s month to month. Enterprise terms are set in each agreement.

A dedicated billing team, regular consultation with our billing lead, benchmarks against similar ABA agencies, a web portal for reports and requests, and project based work such as backlog cleanup, credentialing, and payer setup. Volumes, pay as you go rates, and terms are set to fit your agency.