Search payors, sections, states, CPTs, and pages.
Policy-change alerts and source-cited billing rules for 192 ABA payors. When an auth window shrinks or a modifier flips, you hear about it that day — with the source document linked, so a 45-minute portal dig becomes a 2-minute spot check.
Search a payor, see the rules, get alerted when they change.
It's not a staffing problem. It's a systems problem.
When your billing agency manages your payor relationships, they hold the institutional knowledge — auth windows, modifier rules, documentation quirks, escalation contacts. Switch agencies and you start from zero. That's an unnecessary dependency your practice doesn't need to accept.
Payor rules change constantly — and the complexity is staggering. A modifier requirement shifts here, a reauth window shortens there, a new documentation standard rolls out with 30 days' notice. Practices without a tracking system absorb these changes as denials, not alerts.
Tracking 192 payors manually — each with its own portal, policy cadence, and documentation quirks — is a full-time job. ABA Insight gives independent and mid-size practices the same systematic coverage without the overhead.
Type a payor name and instantly see authorization windows, modifier requirements, documentation standards, and submission deadlines — all in one place.
Every field is structured and current. Filter by state, plan type, or CPT code. Compare two payors side by side before accepting a new contract.
Severity-coded alerts notify your team when a payor updates its rules — before the denials arrive. Your weekly digest keeps everyone current.
Every denial your team absorbs because a rule changed — and no one caught it — is the real cost of not owning your payor intelligence.
Your assumption, not our promise — drag it to whatever you believe.
Not in an agency retainer you pay to access indefinitely.
Severity-coded alerts when payors update their rules. Anthem's January 2026 shift to weekly unit tracking cost practices thousands in denials — practices that caught it early didn't have to find out from an EOB.
Track denial patterns by payor, CPT code, and root cause. Import ERA 835 files to auto-populate your denial library.
Initial auth durations, renewal windows, unit tracking cadence, and submission deadlines for 192 payors — now searchable in seconds.
Payor-by-payor modifier requirements for 97151–97158, including max units per day and required combinations.
Side-by-side comparison of any two payors across 12 fields. The analysis that used to require a call to your billing agency — done in 10 seconds.
Interactive choropleth showing ABA legislative threat levels by state — critical bills, rate cuts, and hour caps at a glance. Public and free.
View State MapCritical changes (auth window shrinks, new modifier requirements, FBA mandates) hit your inbox the day we detect them. Routine changes roll into a weekly digest. Every change links back to the source document.
Severity is decided by an LLM against your watched payors — calibrated to surface what actually moves your denial rate.
Auth submission window reduced from 30 days to 14 days. Affects all 97151–97158 codes.
New required modifier (HM) for 97155 supervision codes when delivered in clinic.
Telehealth 97153 coverage confirmed for POS 02 and POS 10.
Pre-filled with a real-world scenario. Adjust the sliders to match your practice.
Adjust the sliders to match your practice. Pre-filled with a real-world scenario.
Full breakdown: rework costs, unrecovered revenue, payback period, and shareable link
Industry data: ABA practices typically see denial rates between 8–25%. MGMA benchmarks suggest each reworked claim costs $57 in staff time, and 35% of denied claims are never successfully resubmitted. Proactive payor monitoring is the most direct lever for reducing preventable denials.
Estimates use MGMA/HFMA industry benchmarks ($57 rework cost/claim, 65% unrecovered rate, $150 avg claim value). Individual results will vary based on payor mix, billing complexity, and team adoption. This is not a guarantee of outcome.
The product is built for a specific kind of ABA operation. Here's the honest picture.
Every record is source-linked, timestamped, and reviewed on a defined schedule.
Every data point links to the official payor policy document, provider manual, or Medicaid bulletin it came from. No secondhand aggregators.
Each record links its source document and shows when our agents last checked it — plus the actual effective date of the most recent policy change.
Monitoring agents check every registered payor source daily; verified changes publish and alert the same day. A human editorial pass re-reads each payor's full record on a monthly/quarterly tier on top.
Spot something wrong? Submit a correction from any payor record — triaged on a rolling basis and updated when confirmed against the source.
Start free. Upgrade when you're ready — pay only for the seats you use.
Pick 3 anchor payors — full data + alerts, yours forever. No credit card.
Full payor database, real-time alerts, denial intelligence, and team collaboration for your billing team.
Second 12.5% rate reduction effective April 1, 2026
Initial authorization window extended from 6 to 9 months
Functional Behavior Assessment now required at every renewal
Telehealth ABA now requires in-person assessment every 6 months
The things practices ask before switching from their billing agency's spreadsheet.
We monitor all 192 payors so you don't have to. When authorization rules, modifier requirements, or timely filing limits change, you'll know before it hits your claims.
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Tracking 192 payors is genuinely hard. Most practices outsource that complexity to a billing agency and pay for access to the knowledge indefinitely. ABA Insight is the alternative — structured, searchable, and owned by your organization.
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