Built by operators who ran ABA billing.

Get paid the first time. Not the third.

Q: 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.

Q: 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.

Q: 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.

Q: 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.

Q: 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). Core has a 10-licence minimum, so accounts start at $300/month.

Q: Does Wilma support in-house billing or do I need a billing service?

Wilma is built so you can bring billing in-house and keep the 4–8% of collections a billing service charges. 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.

Q: 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.

Q: 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.

Q: How long does billing implementation take?

Small practice: 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.

Q: 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.

Pre-submission scrubbing. Per-payer rules. Authorization tracking. ERA auto-posting. Denial workflow. The ABA billing platform that prevents denials instead of reporting them.

clean claim rate: 98%
ABA billing code coverage: CPT® + HCPCS
scrubbing every claim: Pre-submit
ERA posting: Live

What is ABA billing software?

The revenue-cycle platform for ABA practices — built for CPT® and HCPCS.

ABA billing software handles the revenue cycle specific to Applied Behavior Analysis: insurance capture at intake, authorization unit tracking, claim creation with ABA-specific billing codes (CPT® and HCPCS) and per-payer modifier rules, pre-submission scrubbing, EDI clearinghouse submission, ERA posting, denial management, and patient billing.

ABA billing is uniquely complex. The ABA billing code set — CPT® for assessment, treatment, and family/group services, plus HCPCS where payer rules require it — has specific time-unit and modifier requirements. Payer policies vary on telehealth, group services, and supervision billing. Authorizations have fixed cycles and unit caps. Modifier mistakes and authorization gaps drive the majority of denials. Generic medical billing adapted for ABA will always be working around these specifics. ABA-native billing encodes them.

Insurance captured at the front door. Authorizations tracked before they matter.

Insurance is captured at intake — it is on the record before the family finishes the first form. Authorization units decrement per session. Renewal cycles surface weeks ahead, with clinical documentation ready for the BCBA to review.

Intake-time insurance capture

Plan and member details captured on the record at intake.

Authorization tracking

Unit balance live. Alerts weeks ahead of renewal cycles.

Payer-specific rules

Medicaid, commercial, TPA — each set of rules encoded natively.

Clinical prep for renewals

Progress data, goal mastery, session history — assembled for your BCBA.

ABA billing codes (CPT® and HCPCS), encoded to the practice’s rules.

The full ABA billing code set — behavior identification assessment, adaptive behavior treatment, family guidance, group services — with correct time units and modifier sets per payer. Plus HCPCS where Medicaid or specific payers require it. Not generic medical billing adapted for ABA. Native.

Assessment codes

Time units, documentation, authorization match — assessment workflow encoded.

Protocol treatment codes

RBT delivery, group rules, supervision requirements built in.

Family & group services

Family guidance, multi-family group, protocol modification with groups.

CPT® + HCPCS coverage

Both code sets supported — payer rules dictate which apply per claim.

Claims caught in the billing queue. Not in a 60-day denial.

With the AI add-on (+$20/user/mo, layered on Core), every claim runs through payer-specific scrubbing before it leaves — modifier sets, authorization units, documentation completeness, medical-necessity language. Gaps surface live for your biller to correct. Clean claim rate typically 98%.

Per-payer rule engine

Modifier logic and documentation requirements by payer.

Documentation gap detection

Missing signatures, incomplete notes, absent language — flagged pre-claim.

Authorization match

Units, dates, service codes — checked against the active authorization.

Billing queue, not a spreadsheet

Gaps routed to the right biller with context. Fix in two minutes.

Submission and reconciliation, automatic.

EDI clearinghouse integration. Electronic Remittance Advice posts to the right claim automatically. Denials route with context to the right team — not a staff scramble.

EDI clearinghouse integration

Standard 837/835 flows. Status tracked end-to-end.

ERA auto-posting

Payments applied to claims live. Reconciliation is a dashboard, not a job.

Denial workflow

Routed to the right team with context, categorized by root cause.

Patient billing

Statements, payment plans, online payment — all native.

The numbers that actually matter, live.

Clean claim rate. Days in AR. Denial reasons. Payer mix. Productivity per BCBA. All live, all in one place. No warehouse delay. No exported CSVs.

Clean claim rate

First-pass acceptance across payers. Tracked continuously.

Days in AR

Aging buckets, payer-specific trends, collection velocity.

Denial root cause

Coding issues, authorization gaps, documentation — categorized automatically.

Productivity by provider

Billable hours, clean claim rate, denial rate — by BCBA and RBT.

Bill across locations and states without workarounds.

NPI, tax ID, and billing address per location. State-specific billing-code and modifier rule packs applied per claim. Cross-entity rollups for ownership reporting.

Per-location billing identity

NPI, TIN, address — correct on every claim.

State rule packs

State-specific billing-code, modifier, and EVV rules per claim.

Credential tracking

BCBA & RBT certification expirations alerted across locations.

Rollup reporting

Cross-entity financial and operational rollups for ownership.

Buyer's Checklist

Evaluating ABA billing software? Demand every line.

FAQ

Questions operators ask about ABA billing.

What is ABA billing software?

What billing codes does Wilma support?

What is pre-submission claim scrubbing?

How is authorization tracking handled?

How much does Wilma billing cost?

Does Wilma support in-house billing or do I need a billing service?

Which EDI clearinghouses does Wilma support?

How does Wilma compare to CentralReach billing?

How long does billing implementation take?

Can I migrate my billing history?

Is Wilma HIPAA compliant?

Customer Story · Billing & RCM

How a practice recovered written-off revenue — and stopped paying a cut of every dollar

Why they brought billing in-house instead of surrendering a percentage of every collection.

See billing that prevents denials — not reports them.

Thirty minutes. Bring your own billing codes, modifier challenges, and a recent denial. We’ll show you how it would have been caught.

CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data are copyright © American Medical Association. All Rights Reserved. CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The AMA does not directly or indirectly practice medicine or dispense medical services.

Choosing a billing system

How to evaluate ABA billing software

ABA billing fails in specific, repeatable ways — unit math, modifiers, authorization balances and concurrent-session rules. A generic medical biller handles most of a claim and leaves the part that is actually hard.

1Does it know ABA coding, or general medical coding?ABA runs on a small set of codes billed in 15-minute units with payer-specific modifier requirements that differ between commercial plans and state Medicaid. A system that treats these as ordinary CPT codes will produce claims that are technically valid and get denied on rules it never checked.Red flag: Modifier rules maintained by you in a spreadsheet and typed in per claim.
2Does it check the claim before the payer does?The economics of denials are lopsided — preventing one costs seconds, working one costs a biller twenty minutes and delays payment by weeks. Pre-submission scrubbing should check modifier sets, unit math against session duration, remaining authorization balance, and whether the documentation supporting the claim actually exists and is signed.Red flag: Scrubbing that validates format only. Catching a malformed field is not the same as catching a claim that will be denied for exceeding the authorization.
3Do authorizations decrement automatically?Nearly every avoidable ABA write-off traces to a session delivered against an authorization that had run out or expired. Units should decrement as sessions are delivered, remaining balance should be visible when the appointment is booked, and renewals should surface with enough lead time to obtain them.Red flag: Authorization tracked as a start date, end date and total, with nothing decrementing it as you deliver.
4Do payments post back automatically?ERA auto-posting against the originating claim is the difference between reconciliation being a process and being a person. Without it, someone reads remittances and types payments in — slowly, and with an error rate that shows up months later as unexplained AR.Red flag: ERA files downloaded and reconciled manually, or posting that cannot handle a partial payment with a contractual adjustment.
5Can you see AR by the thing that caused it?An aging report by days is a symptom. What you need is AR grouped by payer, denial reason and responsible owner, so the same denial reason appearing forty times is visible as one fixable problem rather than forty individual follow-ups.Red flag: Denial reasons stored as free text, which makes them uncountable and therefore invisible.

Before you sign

Questions worth asking on the demo

Show me a claim being scrubbed and failing, and tell me which rule caught it.
What happens when a session is scheduled against an authorization with insufficient remaining units?
Show me an ERA posting against a claim with a partial payment and a contractual adjustment.
Can I see AR grouped by denial reason, and is that reason a structured field?
Are clearinghouse or per-claim fees included in the quoted price, or billed separately?
When I switch, what happens to open AR in my current system?

Glossary

The terms you will hear

Clean claim rate: The share of claims accepted and paid on first submission without correction. The single most useful number for judging whether a billing setup is working.
Modifier: A two-character code appended to a CPT code that qualifies the service — who delivered it, in what setting, under what supervision. Requirements vary by payer and are a leading cause of ABA denials.
Contractual adjustment: The difference between billed charges and the contracted allowed amount, written off rather than collected. Distinct from a denial, and posted automatically from the remittance.
Clearinghouse: The intermediary that validates and routes claims to payers and returns acknowledgements and remittances. Sometimes bundled into a platform, sometimes a separate vendor with its own per-claim fee.
Timely filing: The payer's deadline for submitting a claim after the date of service. Missing it makes the claim unbillable outright, which is why aged unsubmitted work is more urgent than aged denials.
Accounts receivable aging: Outstanding balances bucketed by how long they have been open. Useful as a symptom; actionable only when it can also be grouped by payer and denial reason.

Keep reading

Related guides on running an ABA practice — the same operation, from a different angle.