Finni Case Study

Status Quo before Silna 

Monique’s main goal within her organization is to ensure high-quality care for all her patients. For this to happen, her clinical staff should be able to focus solely on patient care without being burdened by administrative paperwork. Before using Silna, Monique handled all prior authorizations personally, wanting to avoid imposing the administrative burden on her BCBAs. This meant she spent over 55 hours each month tracking authorization utilization, reminding clinical staff to create new treatment plans, filling out authorization forms, and constantly following up with payors on the status of their authorizations. All of this was in addition to her regular responsibilities, making it challenging to keep up with the authorization requirements. Monique stated:

“Before Silna I was mostly doing prior authorizations at night time when no one was messaging me, and this really impacted my work life balance”

Prior authorizations can be complex, and their requirements vary widely depending on the payor. Monique was spending a significant amount of time on each authorization: 

Average time per prior authorization

• Medicaid: 25 minutes per authorization
• Commercial: 1.5 hours per authorization
• Tricare: 3 hours per authorization

Eligibility Checks

Before Silna, Monique’s practice used a low-cost eligibility solution that batch-checks all patients’ eligibility within 4 days of the beginning of each month. Unfortunately, this vendor frequently returned reports for patients as eligible when they were actually inactive, a common issue in the industry. On one occasion, the New Mexico practice provided 100 hours of direct RBT work over a 4-week span to an ineligible patient, resulting in a loss of over $10,000 in revenue.

Tracking Authorizations

Like many providers, Monique used spreadsheets to track authorization expiration dates, which required hours of manual work and created the risk of human error. The potential for authorizations to slip through the cracks was a significant concern due to the potential loss in revenue and gaps in patient care. Additionally, Monique also maintained a separate spreadsheet to track the constantly changing prior authorization requirements, which could differ even within the same payor. Tracking prior authorization processes was an ongoing task that required continuous investment.

Implementing Silna

Every provider in the ABA space is familiar with the horror stories of implementing a new software vendor (such as an EHR), and the almost guarantee of the process taking months longer than anticipated. Silna, however, has invested significant time into making the implementation process as easy as possible. The entire end-to-end implementation to get Monique’s account fully up and running – from deciding to work with Silna to going live – took under 10 days. 

Support

Working with Silna, Monique valued reliability above all else. She now has the peace of mind of knowing that I have a partner she can trust with critical business functions.

“In this field of ABA, it is really difficult to find a company with great support that you can truly rely on and call on a moment’s notice with any questions. Our past vendor was impossible to get in touch with, but Silna, from day one, has sought our feedback and then implemented those changes immediately. It is refreshing to partner with a vendor who feels like they truly value your time and feedback.”

Silna’s Impact on the Business 

Partnering with Silna has reduced Monique’s administrative work by 55 hours per month, allowing her to increase practice revenue and enhance the quality of care provided. With the newfound time, Monique now dedicates over 30 hours monthly to quality checks, which can be billed to insurance while ensuring optimal patient care. 

“I was the one previously doing all of these authorizations. Since working with Silna I have more time to focus on providing the best clinical care.”

Though the revenue increase is significant for Monique’s business, the most substantial impact for her is improving the quality of care. Above all else, Monique values being able to provide the best care possible, and with Silna, she has eliminated the barriers to fully focusing on patient care.

Eligibility Checks

With Silna, Monique finally feels like she has a partner that she can fully trust with benefit and eligibility checks. Since Silna was implemented, her time to complete an eligibility check has dropped from 4 business days to 1. Monique can confidently say that Silna has been 100% accurate with each eligibility check. She can now provide care to patients without ever having to worry about the likelihood of providing services to an ineligible patient. 

Recommendation to an ABA provider considering Silna 

“To any provider considering working with Silna, go for it! I highly recommend them. As a practice owner in the ABA space, finding a vendor you can trust to complete critical business tasks accurately is challenging. However, I have found that with Silna, they make it easy to get up and running in a matter of weeks, and if I ever have questions about anything, I am confident that their team will be there to provide answers. Do yourself a favor and speak with Silna so you can experience the same incredible impact on your organization that I have seen at my New Mexico practice.”