Arizona Autism United: their journey from startup to ABA industry leader

The early days of AZA United… and applied behavior analysis (ABA).

 

How it all started:

When the organization started 15 years ago, ABA was still largely unknown in Arizona. Founder and CEO Dr. Aaron Blocher-Rubin, BCBA, recalled, “We pretty much had one funder, and that was our state’s DDD, Division of Developmental Disabilities.”

 

At the time, the services the organization provided weren’t specifically ABA, but basic-level direct care, like habilitation and respite. They tried to provide a hybrid approach to give clients more training, better goals, data, and so forth -- but it was very limited.

 

Over the next 10 years, things began to evolve as ABA became more recognized. The DDD program created what Aaron refers to as an “ABA-lite” model. Electronic medical record (EMR) and practice management (PM) software weren’t yet necessary because billing was so straightforward. “It was simple. There were 3 billing codes… no modifiers, and we just billed the state and they paid us in 30 days,” Aaron said.

 

The growth of ABA -- and the transition from paper to electronic software.

Over the next few years, AZA United’s operational needs continued to grow as ABA billing became more complicated. They quickly realized their old systems simply wouldn’t cut it. “It was obvious that we needed to go electronic for insurance billing,” Aaron said.

 

Initially, they decided to go with a simple and affordable solution they learned about from some peers in the industry. “It was a month to month contract and we thought, all right, let’s just get started here,” said Aaron. “[It] carried us for several years, but during that time things continued to evolve rapidly.”

 

Aaron said that their program really started to grow, with nearly all clinical services shifting away from the DDD to insurance billing -- whether Medicaid or commercial. “It became obvious that we needed something a lot more robust that could grow with us as we continued to scale up.”

 

Growing pains.

As ABA continued to gain traction, so did the complexity of providing and billing for services. Insurance requirements were becoming more complicated, electronic visit verification (EVV) entered the scene, and changes were happening in quick succession.

 

Rapid industry changes occurring in parallel with the organization’s growth left little time to learn these new processes, particularly the intricacies of insurance and billing changes. They were limited by the capabilities of the system they were using at the time, which lacked the functionalities needed to meet these new requirements.

 

“We made mistakes,” Aaron said, “And I know for certain that there was a period where we underbilled, because we didn’t really understand the way codes and billing and modifiers and all those things worked. I know that we missed a lot of opportunities because we didn’t fully understand the intricacies of insurance billing.”

 

As a growing organization in an evolving field, it became imperative to find an ABA-specific software that could adapt to any industry change thrown their way -- and one that was robust enough to streamline complex billing processes, facilitate optimization across all business areas, and keep them compliant with state and federal regulations.

 

The search for a better solution.

AZA United explored a number of different softwares, from traditional hospital-type EMRs and large systems to smaller ones. Aaron knew about CentralReach from ABA conferences as well as recommendations from other providers, but wasn’t clear on the capabilities offered.

 

However, once he learned about the ways CentralReach had evolved -- its various mergers and areas of investment -- he decided to take another look. He was excited to learn that many of the features and integrations were exactly what AZA United needed.

From there, Aaron said “It was very unanimous among our leadership team that [CentralReach] was definitely going to be the best option for us.” In 2019, they signed the contract.

 

One year with CentralReach.

“We launched in June last year. So we’re at exactly one year, now. And it’s been great,” Aaron said. “It’s definitely solved a lot of issues for us. I think what I’ve most appreciated is the level of support. And I’ve told [CentralReach CEO] Chris Sullens this, I don’t know any technology products that give us this much support.”

 

Aaron mentioned their Customer Success Lead, saying, “we work with [our CSL] very frequently, and she pretty much gives us unlimited time. It’s just so helpful because there are so many little things we are trying to get right. Having that kind of guidance for a system this complex and this important just makes all the difference.”

 

Optimization at all levels -- from billing, and beyond.

CentralReach has helped the team at AZA United automate their revenue cycle management, enable maximization of claims, and correct costly billing errors -- all of which were impossible using their old system. Their new billing processes have not only helped avoid mistakes that cost them revenue in the past, but, as Aaron put it, “forced us to learn a lot that we just didn’t know before.”

 

CentralReach has helped capture revenue that might otherwise have been left on the table. Referring specifically to Medicaid, Aaron said, “there’s quite a variance there... it can be almost double the reimbursement rate with some plans if you use the correct modifiers appropriately. CentralReach has made it much easier for us to streamline the setup correctly for each clinician.”

 

CentralReach’s transition of company data from paper and local storage to the cloud helped the team prepare for the impact of COVID-19. While in the process of getting ramped up on the new system, they were able to pivot to telehealth as needed.

Overall, Aaron said they’re simply able to function more efficiently and with increased peace of mind using CentralReach. “I highly recommend [CentralReach] to people and I think it’s the obvious choice, frankly, if you’re in this field.”