How Can You Reduce AR Days and Improve Cash Flow in ABA Billing?

As ABA therapy grows into a $2 billion industry, many practice owners are still caught in a frustrating cycle of delayed reimbursements. Though the services are in high demand, the financial strain of managing receivables continues to affect the day-to-day operations of clinics across the U.S. In a perfect world, days in accounts receivable would hover around 30 to 40. Unfortunately, many ABA clinics report AR days exceeding 60 or even 90, making it tough to meet payroll, invest in growth, or maintain consistent client care. In this post, we’ll break down why AR days remain high in ABA billing and share strategic, real-world solutions to reduce delays, recover lost revenue, and stabilize your practice financially.

Understanding the Current AR Days Challenge in ABA Therapy

The world of Applied Behavior Analysis (ABA) therapy has seen remarkable growth in recent years. In fact, the industry now generates over $2 billion annually in the U.S. alone. While that’s a clear sign of rising demand and expanding access to care, it also masks a pressing financial issue that many providers face: slow and inconsistent reimbursements.

Even as demand increases, many ABA clinics find themselves burdened by delayed payments that disrupt their financial stability.

 The core problem? 

For ABA practice owners, one number can make or break financial stability—days in accounts receivable (AR). This figure shows how long it takes to get paid after delivering services. While the goal is to keep AR days under 40, many clinics are seeing them climb past 60 or even hit the 90-day mark. When payments are delayed this long, it can quickly disrupt cash flow, making it tough to pay staff, manage expenses, or invest in the growth of the practice.

Eye-Opening Industry Statistics

These recent figures paint a concerning picture of the financial challenges in ABA therapy:

• More than 70% of ABA practice owners report having dangerously low cash reserves.

• In 2020, the U.S. spent $238 billion on behavioral health services—highlighting its growing importance in healthcare.

• Industry best practices suggest keeping AR days under 50, with top-performing practices maintaining a range below 40 for better financial health.

• To monitor this effectively, many clinics rely on the days in AR formula, which provides a snapshot of how efficiently revenue is collected over time.

Understanding how to calculate this simple formula allows providers to track revenue trends, anticipate cash flow issues, and make more informed financial decisions.

What’s Causing the Delays?

Let’s break down some of the most common reasons AR days keep creeping up in ABA practices:

Delays in Prior Authorizations

ABA services almost always require pre-approvals. These authorizations often need renewal every six months. Miss one, and you're looking at weeks—or even months—of revenue sitting idle.

Documentation & Coding Mistakes

Incorrect use of CPT codes like 97151, 97153, 97155, and 97156 can cause claim denials or delays. Every payer has unique requirements, and minor documentation errors can disrupt the revenue cycle significantly.

Denials Are Too Common

Denial rates in ABA billing can range anywhere from 6% to 27%, largely due to issues like incorrect benefits, missing documentation, or lack of clear medical necessity.

Insufficient Billing Support

Not all clinics can afford an in-house billing team. Without access to specialized ABA billing services, many providers fall behind on submissions and follow-ups, missing crucial revenue.

How These Delays Affect ABA Practice

The consequences of high days in AR reach far beyond the billing department:

• Cash Flow Challenges: When payments are delayed, it becomes harder to cover payroll and keep up with vendor obligations on time.

• Team Burnout: Admins spend hours chasing claims instead of helping families.

• Lost Revenue: Older claims often slip through the cracks. Once they’re over 120 days, collections become far less likely.

• Stress & Uncertainty: More than 70% of ABA business owners cite financial stress from poor AR management.

How to Bring AR Days Under Control

If you're serious about financial health, these proven strategies can help cut your AR days dramatically:

Strengthen Pre-Visit Insurance Checks

• Verify benefits 48–72 hours before each session.

• Discuss payment responsibilities with families at intake.

• Use automation to reduce eligibility verification errors.

Upgrade Your Billing Tech Stack

Invest in ABA billing software that tracks claims in real time. Tools that automate Electronic Remittance Advice (ERA) processing and catch coding issues before submission can transform your revenue cycle.

Build an Aging-Based Follow-Up System

• Prioritize older and high-dollar claims each week.

• Set response expectations through Service Level Agreements (SLAs) with your payers and team.

Tackle Denials with Precision

With structured ABA denial management, you can:

• Classify and analyze denial reasons.

• Build a reliable appeals process.

• Train your team to avoid repeat issues.

Real-World Example: How One ABA Clinic Turned Around Its Billing Struggles

A mid-sized ABA practice in Phoenix was dealing with AR days between 60–90 and $250,000 in monthly billing. After outsourcing to a professional billing team, they saw:

• A 78% reduction in claim denials

• 40% faster collections

• AR days slashed to under 45

Key to their success? 

They combined tech, aba practice management software, and proactive billing oversight.

What makes Cube Therapy Billing different from other ABA billing companies?

At Cube Therapy Billing, we've supported countless ABA clinics in overcoming cash flow roadblocks and regaining financial stability. We offer a complete solution—not just for billing, but for managing every stage of the revenue cycle.

What services does Cube Therapy Billing offer?

Expert ABA Billing Specialists: ABA billing company handle coding, payer rules, and clean claim submissions to maximize first-pass acceptance.

Insurance Authorization & Benefits Tracking: We manage everything from pre-authorization to timely renewals, preventing billing gaps.

Structured AR Follow-Up by Aging Buckets: We actively monitor and follow up on claims in 0–30, 31–60, 61–90, and 90+ day categories.

High-Impact Denial Management: With a 70–80% recovery rate, we appeal and recover denied claims with precision.

Credentialing Services: We keep your therapists credentialed and compliant, minimizing delays in reimbursement.

Real-Time Revenue Dashboards: Stay informed with full visibility into your days in AR, claim status, and collection rates.

Cube Therapy Billing brought our AR over 90 days down by more than 50% in just three months.

In-House vs. Outsourced AR Management

Metric	In-House	Outsourced (e.g., Cube Therapy)
AR Recovery Rate	Unpredictable	Up to 40% improvement
AR > 90 Days	Common	Cut in half in 90 days
Staff Focus	Divided across tasks	65% more time spent on client care
Compliance	Depends on training	Always HIPAA-compliant and audit-ready

When managed by experts, ABA therapy billing and insurance services shift from being a liability to a strategic advantage.

Track These KPIs to Stay Ahead

Every ABA clinic should track:

• Days Sales Outstanding (DSO)

• Net Collection Rate (aim for 95–99%)

• Denial Rate (keep it under 5–10%)

• AR Aging Buckets—especially claims over 90 and 120 days

If you’re wondering how to calculate days in accounts receivable, remember:

Use these figures to make real-time adjustments and stay on top of your revenue cycle.

Looking Ahead: What’s Next in AR Management

• AI-Powered Billing Tools: These reduce human error and streamline workflows.

• Telehealth Billing: Adds complexity, but offers expanded reach—requires billing systems that can keep up.

• Compliance is Tightening: With audits and payer scrutiny increasing, practices must be extra vigilant.

• State-Level Changes: With 36 states mandating ABA coverage, opportunities—and responsibilities—are growing fast.

FAQ

1.What is meant by account receivable?

Accounts receivable is the money owed to your practice for services you've already delivered. It represents unpaid invoices from clients or insurance companies waiting to be collected.

2.How to improve accounts receivable management?

Stay on top of claims, follow up quickly, communicate clearly with payers and clients, and use smart billing tools to ensure faster payments and fewer delays.

3.What are the challenges in accounts receivable?

Late payments, denied claims, unclear billing, and poor follow-up can all slow your cash flow. Without a solid process, collecting what you’re owed becomes an uphill battle.

Conclusion

Keeping your days in accounts receivable under control isn’t just about tracking numbers—it’s about protecting the future of your ABA practice. Whether you’re running a small clinic or scaling a larger provider group, streamlining your AR process is essential.

At Cube Therapy Billing, we do more than handle your claims—we act as a true financial partner. From accurate coding to quick denial resolutions, our goal is to help you stay in control of your revenue and keep your practice operating without the financial stress.