Operations
How to Build an ABA Authorization Tracker
The columns, alerts and weekly rhythm that keep sessions from running past an authorization.
An authorization tracker is the single most effective tool against unbillable sessions. Most practice-management systems store authorizations, but a dedicated tracker, or a well-configured report, makes risk visible at a glance and gives one person clear ownership.
The columns you need
| Column | Why it matters |
|---|---|
| Client ID (not full name) | Identifies the client while keeping exposure minimal |
| Payer and plan | Rules differ by plan, not just by payer |
| Authorization number | Needed on claims and payer calls |
| CPT code | One row per code per authorization |
| Start and end dates | Drives renewal alerts |
| Units approved | Total or per-period, as the payer defines it |
| Units scheduled and used | Shows burn rate against the approval |
| Units remaining | The number everyone actually looks at |
| Re-authorization status | Not started, documents requested, submitted, pending, approved, denied |
| Submission date and reference number | Proof of timely follow-up |
| BCBA and owner | Who provides documents, and who follows up |
Unit math
Most ABA codes are billed in 15-minute units, so four units equal one hour. Track remaining units, not remaining hours. If the payer authorizes per week or per month, track usage per period too, because a client can be fine on total units and still over the weekly cap.
Alerts that prevent problems
- 60 days before end date: request the updated assessment and treatment plan from the BCBA.
- 30 days before: submit the re-authorization if documents are ready; escalate if they are not.
- 14 days before: follow up with the payer and record the reference number.
- Usage over 85% of approved units: alert the scheduler and clinical director.
- Scheduled hours above authorized hours for the coming week: fix the schedule before sessions run.
Payer timelines vary, so adjust these windows to your slowest payers.
The weekly rhythm
- Monday: compare next week’s schedule to remaining units for every client.
- Midweek: work the re-authorization queue: documents, submissions, follow-ups.
- Friday: send a short status note to clinical leadership listing at-risk clients and blocked items.
Keep it secure
A tracker contains PHI. Keep it inside your practice-management system or an approved, access-controlled platform with multi-factor authentication. Do not email it as an attachment or keep copies on personal devices.
Ownership matters more than tools
The best tracker fails without a single accountable owner. If authorizations are everyone’s side job, they become no one’s job. That is why the authorization coordinator is often the first operations role a growing ABA practice adds.
Short-staffed on the operations side?
Skills-tested remote ABA operations staff.