ABA billing software guide. CPT codes 97151–97158, pre-submission scrubbing, EDI clearinghouse integration, authorization tracking, denial workflow.
Frequently asked questions
What is ABA billing software?
ABA billing software handles the revenue-cycle workflow for an Applied Behavior Analysis practice: insurance capture at intake, authorization tracking, claim creation with ABA-specific billing codes (CPT® and HCPCS) and per-payer modifier rules, pre-submission claim scrubbing, EDI clearinghouse submission, ERA posting, denial management, and patient billing.
What billing codes does Wilma support?
Wilma supports the full ABA billing-code stack: the CPT® code set the AMA maintains for ABA (covering behavior identification assessment, adaptive behavior treatment by protocol, protocol modification, and family/group services), plus HCPCS codes where Medicaid or specific payers require them. Each code has specific time-unit requirements and modifier rules that vary by payer — encoded natively, not configured per claim.
What is pre-submission claim scrubbing?
Pre-submission scrubbing is automated checking of every claim against payer-specific rules before it leaves the practice. On Wilma it ships with the AI add-on (+$20/user/month, layered on top of Core $30/user/month) and checks modifier sets, authorization unit balance, documentation completeness, medical-necessity language, and code combinations. Gaps surface in the billing queue so the claim never ships dirty. This is the highest-impact improvement to clean claim rate in ABA billing.
How is authorization tracking handled?
Authorizations are loaded with a unit balance against allowed services, decremented per session, and surfaced live in Core. Renewal cycles are fixed and known — Wilma surfaces upcoming cycle closures weeks ahead with clinical documentation pre-assembled, so the BCBA can write the medical-necessity recommendation without digging for session data.
How much does Wilma billing cost?
Core is $30/user/month and includes the full ABA billing surface: claim creation with ABA-specific codes, modifier rules, authorization tracking, EDI clearinghouse submission, ERA posting, denial management, and patient billing. The AI add-on (+$20/user/month) layers pre-submission claim scrubbing and denial prediction. Most practices that want clean-first-time claims run Core + AI ($50/user/month).
Does Wilma support in-house billing or do I need a billing service?
Most practices on Wilma bring billing in-house and save 4–8% of collections vs. outsourced billing services. The combination of native EDI (Core), pre-submission scrubbing (AI add-on), automated ERA posting (Core), and denial workflow (Core) makes in-house billing tractable even for small practices.
Which EDI clearinghouses does Wilma support?
Wilma integrates with standard EDI clearinghouses that serve ABA practices. Integration scope is confirmed during discovery based on your payer mix and existing clearinghouse relationships.
How does Wilma compare to CentralReach billing?
Wilma's scrubbing (AI add-on) is more granular per payer, the AI-drafted documentation feeds cleaner claims, and pricing is published transparently. See the CentralReach comparison.
How long does billing implementation take?
Solo BCBA: under a week. All other practice sizes — small, mid-size, and enterprise multi-state: 1–2 weeks, including clearinghouse setup and payer rule mapping. Wilma's pre-configured ABA billing rules eliminate the multi-quarter implementation legacy platforms typically require.
Can I migrate my billing history?
Your clinical and operational data migrates during onboarding. For billing, most practices run out open AR in their prior system while new claims start clean in Wilma — the cleanest way to avoid mid-cycle reconciliation. If you need historical billing data imported, we will review options with you during onboarding.
Is Wilma HIPAA compliant?
Yes. End-to-end encryption (AES-256 at rest, TLS 1.2+ in transit), role-based access, full audit logging on every PHI access, and BAAs standard with every customer agreement.