SAMBA ABA · IN-HOME MODEL

Revenue & Authorization Health Check

A 60-second look at where ABA revenue tends to leak, tuned to an in-home practice billing BCBS, Anthem, Alliant, GA Medicaid, Wellpoint & CareSource.

Prepared for Jake Heimovits · built by Laureen Nicholson, AutomatedRCM

No patient data — aggregate numbers only

Active clients 40

Billable hours / client / week 15

Blended reimbursement / hour $62

Claim denial rate 12%

Days to approve a new auth 14

Staff hours / week on auth + reauth 18

Estimated annual revenue leakage

against $0 in annual billings

Denials never recovered

Prior-auth delay loss

Manual auth labor

Recoverable with AutomatedRCM agents

$0 / year

What these three numbers mean

Denials never recovered. In ABA, a big share of denials are fixable — wrong modifier (97153 vs 97155), place-of-service, or a lapsed auth. The ones that never get reworked are pure lost revenue. An AI agent reworks and resubmits them automatically.
Prior-auth delay loss. Every day a new client waits on an authorization is a day of billable therapy you can't start. Agents draft and submit the auth the same day intake closes.
Manual auth labor. The hours your team pours into prior auths, reauths, and tracking authorized units that are quietly burning out mid-cycle. That work is exactly what automates away first.

Want to see the agents actually do this?

I build AI agents for medical billing and revenue cycle. ABA is an area I've been going deep on because prior auth and authorization-unit tracking are exactly the repetitive, high-stakes work these agents are built for. Happy to walk you through a live one.

Book a 15-minute walkthrough See the prior-auth agent in action (demo)

Estimate only, based on the numbers you enter plus ABA industry benchmarks. Assumes roughly 45% of denied dollars are never reworked, new client starts of about 40% of caseload per year, loaded staff cost of $26/hour, and agent recovery of 80% of lost denials, 70% of delay loss, and 85% of manual auth labor. This tool uses and stores no patient or claim data of any kind. AutomatedRCM · getautomatedrcm.com