For many ABA organizations, outdated, paper-based client intake processes lead to long waitlists and inefficiencies in getting children into treatment. Until it overhauled its client intake process, Breakthrough Behavior experienced many inefficiencies related to matriculating children into care.

“Prior to building out our intake department, I can”t tell you how many spreadsheets and paper documents were going back and forth along with paper files for our patient intake documents,” says Maegan Pierce, MA, BCBA, founder and CEO of Breakthrough Behavior, which serves nearly 300 clients in Florida, California, Virginia, and Maryland. “We weren’t utilizing electronic and digital resources to our advantage.”

In a recent BHCOE webinar, Building a World-Class Intake Department, Pierce and Amanda May, Breakthrough Behavior operations manager, shared their suggestions for building a world-class intake department.

Appoint an Operations Leader

The first step for Breakthrough Behavior was hiring Amanda May as operations manager to analyze the organization”s various intake processes, figure out what wasn’t working and establish a more efficient system. The organization wanted a standardized system for all of its locations.

Pierce says that a single ABA provider or a small practice may not have the need or resources to hire a dedicated operations manager, but recommends having one person in the practice who dedicates a good portion of their time to optimizing and managing the intake process. The ideal candidate has a business operations background with a firm understanding of revenue cycle.

The operations person should develop written standard operating procedures that clearly define each step in the intake process. This reduces ambiguity and ensures each member of the team understands expectations.

Establish an Intake Team

After May spent a few months optimizing the intake process, the organization hired an intake team. The team has five essential functions:

  • Waitlist management: Entering patient information into practice management software, communicating with families.
  • New client contacts: Managing contacts from insurance companies, referrals from providers, and inquiries from events and word of mouth.
  • Active intake: Verification of benefits, gathering documentation, and obtaining assessment authorizations.
  • Inter-department communication: Handing the patient off to the clinical team, communicating with the insurance authorization department.
  • Reporting: Developing reports to keep administration updated on waitlist numbers, conducting system audits.

Prior to hiring the team, intake was a disjointed process, with multiple people handling various aspects of intake for each client. Clients now have one point of contact for the duration of their intake.

“The intake team has been a game-changer,” says Pierce. “We’re getting kids into care faster and better aligning our hiring timelines with intake timelines. When our system triggers a BCBA hire, we know exactly how long it”s going to take us to get them matched up with a full caseload. So, there”s a lot of predictability, which has helped improve our profitability.”

Transition From Spreadsheets to Software

Like many practices, Breakthrough Behavior previously managed its waitlists and intake process with spreadsheets. In addition to the potential for user error, such as accidentally deleting important patient information, emailing spreadsheets is clunky and inefficient and can potentially violate HIPAA.

The organization designed an intake system that could be managed completely within its practice management software, Central Reach. The team attaches labels to each step in the intake process, such as “waitlist,” “benefits verification” and “waiting to be scheduled.” The intake specialist changes the label each time a client moves into the next stage of intake, enabling the team to make sure each child is matriculating smoothly through the process.

Users can quickly see how many kids are on the waitlist or are in the active intake for each region. This provides accurate and powerful metrics to determine hiring needs or whether to open a new clinic. The software also allows users to store notes, contacts, or information related to care, ensuring important details are available to everyone who will have contact with a patient.

“We’re now able to make decisions based on data that we have at our fingertips,” says Pierce. “How powerful is that?”

Pierce says practices that don”t have practice management software can still digitize their intake process cost-effectively with a customer relationship management system, such as Salesforce or SugarCRM. ABA therapists need to make sure that whatever tool they use is HIPAA compliant.

Breakthrough Behavior also moved away from paper-based patient intake forms. Families now complete forms online, which has decreased the turnaround time for getting completed forms back.

Actively Manage Your Waitlist

Breakthrough Behavior established an intake funnel to track where clients are in the process before they get into active care. The upper funnel represents children in the verification of benefits, client paperwork, and initial authorization for the assessment stage. The mid-funnel children are in assessment or are pending a service authorization. Finally, kids in the low funnel are waiting to be scheduled.

The intake funnel helps the team manage the waitlist and keep families informed about the timeframe for getting children into care. Families on the waitlist receive a monthly email that includes free and low-cost resources and educational information about ABA therapy.

A better waitlist management system has helped increase revenue for Breakthrough Behavior because the team can offer resources such as social skills groups, camps, and speech therapy while the child is waiting to begin treatment.

Breakthrough also structured compensation for intake specialists based on performance. Compensation is based on getting children out of the intake funnel and into active care within established timelines.

Pierce closed out the webinar by underscoring the importance of developing standard operating procedures. “Having standardized expectations in place for your staff will lead them to be more successful,” she notes.

For more details on how to build a successful intake process, listen to the full webinar.


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