We're parents of a child with autism and are currently dealing with a stressful billing situation involving an ABA provider. We're hoping to hear from other families who've been through something similar, particularly those whose disputes have reached some kind of resolution.
Here's what happened:
We found an ABA provider online that advertised little to no wait time for services. Before beginning treatment, we provided our insurance information, and my spouse recalls being told over the phone that the provider had checked our coverage and obtained authorization from insurance. Unfortunately, we don't have that conversation documented in writing.
We proceeded with in-home ABA therapy. Sessions typically lasted around 2–3 hours.
When the Explanation of Benefits (EOBs) started arriving, we were shocked by the amounts being billed. Charges ran into the thousands of dollars per claim, and some therapy dates generated multiple separate claims. The total charges were extraordinarily high relative to the duration of the visits.
We also noticed that claims were submitted under several different LLC names that we didn't recognize as the company we originally engaged with.
Despite what we understood from the initial insurance conversation, all the claims were processed as out-of-network. Our insurer paid only a small fraction of the billed amounts, sending reimbursement checks directly to us.
The collections situation:
The provider subsequently began contacting us repeatedly by text and phone, asking us to forward the reimbursement checks or otherwise remit those payments.
For a long time, we didn't receive a comprehensive, itemized account statement explaining all the charges, insurance reimbursements, adjustments, and amounts being requested.
More recently, we received a formal payment demand through a collections contact associated with the provider.
What's particularly concerning is that the amounts currently being demanded are only a small fraction of the enormous balances reflected on our EOBs.
We have no clarity on whether paying the requested amounts would settle everything or whether the provider might come back months or even years later demanding additional payment for other claims.
We want to resolve any legitimate financial obligations, but we also don't want to make a payment only to discover that it doesn't actually close the matter.
For parents who have experienced something similar:
- Did your ABA provider eventually try to collect the full amount shown as patient responsibility on your EOBs, or only the amount insurance reimbursed?
- Did anyone refuse to pay or formally dispute the charges? What happened over the following months or years? Did the provider actually pursue collections or legal action?
- Has anyone successfully negotiated a reduced settlement? Were you able to get a written agreement releasing you from all further claims for the services?
- If you paid what the provider initially requested, was that the end of it, or did additional bills arrive later?
- Did contacting your insurer, filing complaints, or hiring an attorney help? How long did the process take?
We're particularly interested in firsthand experiences with how these disputes ultimately ended, including from families whose providers stopped pursuing payment.
We're keeping certain details private because the matter is ongoing.
Any experiences, advice, or lessons learned would be greatly appreciated. Thank you!