Behavior One Case Study

Before implementing Silna, Behavior One Autism Solutions faced significant challenges with their administrative processes, particularly around eligibility checks and prior authorizations. These critical business functions were labor-intensive, requiring multiple staff members and consuming valuable time that could have been spent on patient care.

Eligibility Checks

The eligibility verification process was particularly burdensome, requiring 2-3 staff members to spend 6-8 hours making individual phone calls for each client. This process would often extend over multiple days and created what the team called a “rubber band effect”:

“Previously it took 2-3 people calling and it would take 6-8 hours to call about every single client for the eligibility checks. We would pull in scheduling and our biller to complete these eligibility checks. So if they were doing eligibility that would slow down the scheduling process which would also cause issues in billing and authorizations.”

When staff were occupied with eligibility checks, it slowed down scheduling, which in turn created issues in billing and authorizations.

The process was so demanding that sometimes eligibility checks would be skipped entirely, resulting in denied claims and substantial revenue loss. In one instance, a client switched medical plans, which went undetected for three months, costing the practice over $10,000 in unbillable services. According to the team, such losses extended well into the five-figure range.

Prior Authorizations

Inputting and tracking authorizations was similarly time-consuming, taking 20-40 minutes per authorization. The process lacked a centralized system, leading to miscommunication, errors, and occasional gaps between authorizations. These administrative burdens created a bottleneck that affected the practice’s ability to efficiently provide services.

Implementation

Silna’s implementation process was designed to be straightforward and efficient, minimizing disruption to Behavior One’s operations. The practice was able to quickly integrate Silna’s solutions into their workflow, with immediate improvements in their administrative processes.

Support

The quality of customer support has been a standout feature of the partnership with Silna. The practice rates Silna’s customer service as 10/10, noting that it’s the best among all their vendors. The team particularly values Silna’s accessibility and quick response time, with solutions often provided within minutes or hours of a request. This level of support has been critical in ensuring that Behavior One gets the most value from Silna’s services.

Partnering with Silna has transformed Behavior One’s administrative operations, creating significant time savings and increasing revenue.

Eligibility Checks

Silna’s solution has dramatically improved the eligibility verification process, reducing the time required and increasing accuracy. Most importantly, the accuracy of these checks has been nearly perfect, with the practice reporting 100% accuracy in verifications. This reliability has given Behavior One confidence in their billing processes and prevented potential revenue losses.

Overall Business Impact

The implementation of Silna has had far-reaching effects on the practice:

• Time Savings: Reduced administrative burden on staff
• Increased Revenue: Fewer denied claims and better utilization of staff time
• Improved Efficiency: Streamlined processes and reduced errors
• Better Communication: Single source of truth for all stakeholders

The practice has seen a significant decrease in errors, leading to greater efficiency. They now have a singular source of truth for all processes and no longer rely on a single employee to manage these critical tasks, eliminating a potential point of failure in their business operations.

On the clinical side, staff appreciate the straightforward, user-friendly interface that makes it easy to check authorization status independently, reducing the back-and-forth communication that was previously required.

For ABA providers considering Silna, Behavior One emphasizes the importance of not cutting corners on eligibility verification and authorization management. As their business grew, these processes became increasingly difficult to maintain, ultimately resulting in financial losses.

The practice describes the decision to implement Silna as a “no-brainer” given the critical nature of eligibility checks and authorizations:

“The fact of the matter is that the service is expensive and because 60-70% of your revenue goes to your employees you need to make sure that your employees are productive. We come back to the story that this is a problem that never goes away and you need a solution that scales and a system that works.”

They recognize that the challenges of eligibility verification and authorization management never disappear, making a scalable, systematic solution necessary for long-term success.

For Behavior One Autism Solutions, Silna has proven to be that solution – reliable, efficient, and supported by exceptional customer service.