Switching ABA Billing Services: What Happens to Unpaid Claims?
When you’re switching ABA billing services, your unpaid claims don’t move over on their own and they don’t disappear. They’re still your money, stuck in a gap: the old billing company has stopped chasing them and the new one has never seen them.
If nobody owns those claims, they sit until the payer’s filing or appeal deadline passes. Then the payer owes you nothing and in-network contracts usually bar you from billing the family. Most of the loss comes from small claims nobody was assigned to.
Unpaid claims belong to your practice, not your billing company. Before switching ABA billing services, get a full A/R aging report (a list of every unpaid claim by age), put in writing who works each old claim and sort every claim by payer deadline, soonest first.
Who owns unpaid claims when you switch ABA billing services?
You do. Every claim went out under your practice’s tax ID and NPI, so the payer owes that money to you. Your ABA billing company only works those claims on your behalf (here’s what an ABA billing company actually does day to day).
HIPAA backs this up. Under 45 CFR 164.504(e), your biller’s business associate agreement must require it to return or destroy your patient data when the contract ends. Your service contract covers the rest: notice period, fees on late-arriving payments and system access.
Why unpaid claims slip through the cracks in an ABA billing switch
Here’s how it usually goes wrong when clinics change billing companies:
The old team stops calling payers once notice goes out.
Payer portals were opened under the biller’s admin login, so access ends with the contract.
ERA payment files keep flowing to the old clearinghouse, so payments go unposted.
Authorization numbers and remaining units live only in the old system.
Appeals need session notes with BCBA signatures and nobody knows which claims are waiting.
A stalled claim like this behaves a lot like an ABA claim still pending. It hasn’t been denied, yet the clock keeps running.
ABA billing timely filing limits: how long old claims stay alive
Timely filing is the deadline for a payer to receive your claim, counted from the date of service. Miss it and you get a CO-29 denial, which rarely gets overturned without proof you filed on time.
Payer type | Typical filing window | Why it matters in a switch |
Medicaid | Up to 12 months (42 CFR 447.45); many states set less, like Texas Medicaid at 95 days | Medicaid-heavy ABA clinics feel a switch fastest |
Commercial plans | Often 90 to 180 days, set by your contract | No national rule, so check every contract |
TRICARE | 1 year from the date of service | More room, but don’t let these sink |
Denial appeals | Often 60 to 180 days from the denial date | Open denials can expire before new claims do |
Watch two traps. A claim rejected by the clearinghouse never reached the payer, so its filing clock is still running. And resubmitting a denial without fixing the cause just earns a second one, so review the common reasons ABA therapy claims get denied first.
The ABA billing handoff checklist to send before you give notice
Request these in writing before the contract ends, while you still have bargaining power.
A/R aging report with every open claim by payer and date of service
Last follow-up note per claim, with call reference numbers
Open denials with reason codes, denial dates and appeal status
Authorization numbers, approved and used units and end dates per client
Unposted payments and credit balances
Logins for your clearinghouse, payer portals and CAQH profiles
View-only system access until every old claim is closed
Then update ERA enrollment with each payer. Keep the old biller’s submitter ID active only while it’s finishing claims.
Who should work your old ABA billing A/R after the switch?
The runout is the period after your switch date when someone keeps working claims billed before it. You have four choices:
Old biller finishes its claims: works if it’s paid only on what it collects.
New biller takes everything: one owner, but a heavy first month.
Split by type: old biller closes recent clean claims; new biller takes denials and older A/R.
Your own staff: no runout fee, but it eats front-desk hours.
Work the list in this order: clearinghouse rejections, denials ranked by days left to appeal, claims with no payer response, then high-dollar claims over 90 days. Write off small balances past every deadline with a recorded reason and spell out which company earns the fee on which claims.
When the backlog outgrows your team, dedicated ABA accounts receivable management can work old and new claims side by side so nothing ages out.
Questions to ask a new ABA billing company before you sign
Will you work our legacy A/R and is it priced separately?
How do you sort old claims by payer deadline?
Will you report old-claim recoveries apart from new-claim results?
A vague answer to the first question is a warning sign.
FAQs about switching ABA billing services
Does my old ABA billing company still have to work unpaid claims after I switch?
Only if your contract says so. Most ABA billing agreements end follow-up on the termination date unless they include a runout clause. Before giving notice, get any runout deal in writing, including which claims it covers and how the old company gets paid.
How long do I have to collect unpaid claims after switching ABA billing companies?
It depends on each payer’s filing and appeal deadlines, not your switch date. Medicaid allows up to 12 months under federal rules and many states allow less. Commercial plans often allow 90 to 180 days and TRICARE allows one year from the date of service. Work the nearest deadlines first.
Can a new ABA billing company take over my unpaid claims?
Yes. Unpaid claims belong to your practice, so any billing company you authorize can work them. The new team needs your aging report, past follow-up notes, authorization records, payer portal access and ERA routing moved to its clearinghouse. Without them, older claims can expire while files get rebuilt.
Switch your ABA billing without leaving money on the table
Switching ABA billing services goes smoothly when every unpaid claim has an owner, a deadline and a paper trail before notice goes out. Snapshot your open A/R on the switch date and hold the old company’s final invoice until each claim is paid, appealed, handed off or written off. Rather not run that handoff alone? Pacemave’s ABA therapy billing services cover new claims and old A/R under one team, so your clinicians stay focused on clients.
