Chapter 1
The discovery call
Answer first
A multi-site ABA group was losing paid therapy hours because reauthorizations were tracked in separate spreadsheets per location and renewals slipped past payer deadlines. On the discovery call they asked whether the backlog could be cleared without hiring. It could: one queue, sorted by expiry, run by dedicated staff who start each renewal ahead of the deadline.
Discovery call · transcriptanonymized
PR
Practice
The real problem is reauths. A kid’s authorization runs out partway through the plan and nobody catches it until the claim bounces. By then we’ve already delivered the hours.
S
Staffingly
That’s the exact problem we solve. How are you tracking renewal dates right now?
PR
Practice
A spreadsheet per location. Each office keeps its own. Nobody has the full picture, and we keep adding sites.
S
Staffingly
So here’s the thing. No magic here. It’s really the same process, just that you have dedicated staff taking care of it. We pull every active authorization into one queue sorted by expiry, and each renewal starts ahead of the payer deadline. Simple as that.
PR
Practice
Who actually does the work? We’ve been burned by call centers before.
S
Staffingly
We’re not like a call center that rotates staff between providers. Any task you require, we deploy a dedicated person who’s only for your practice. 95% of our staff come with healthcare educational backgrounds.
PR
Practice
And when that person is sick or on leave? That’s where it always falls apart.
S
Staffingly
Every staff member we deploy, we also train one floater. No expense to you, just in case. If that person goes on PTO or calls out sick, we ensure there is coverage.
The call ended the way most of ours do: a summary of the meeting and the deck went out the same day, and the group agreed to a two-week risk-free pilot. What we found when we opened their books is Chapter 2.
Chapter 2
Research and findings
Answer first
Before anyone went live we audited how authorizations actually moved through the group. The finding was consistent at every location: renewals were reactive. A reauthorization started when a claim denied, not when an expiry date approached. The fix was structural, not heroic: one shared queue, payer-specific lead times, and units tracked against each plan.
What the audit showed. Each location kept its own renewal spreadsheet, and each spreadsheet had its own format, its own owner, and its own blind spots. No one could answer the simple question that decides whether therapy hours get paid: which authorizations expire in the next thirty days, across all sites? Renewal requests were going out late because the trigger was a denial, not a date. And because units were not tracked against the covered allowance, sessions kept being scheduled against authorizations that had already run out.
What we proposed. A single consolidated queue of every active authorization across every location, sorted by expiration date. A lead-time rule per payer, so each renewal starts well before the deadline that payer actually enforces. Units tracking per client, so scheduling stays inside the covered allowance. And dedicated staff on that queue, people who work only for this group, with a trained floater behind them. This is ABA prior authorization outsourcing the way we run it everywhere: no new software to buy, the group keeps its own systems, and the work moves to people whose whole job is watching the calendar.
The group’s leadership reviewed the plan in one sitting. The question that closed it was not about process. It was about pricing, and the answer was the same one we give everyone: $399 flat per week per dedicated specialist, no setup fees, no percentage of revenue.
Chapter 3
Training and onboarding
Answer first
Week one was setup: BAA signed, role-based access provisioned inside the group’s own system, the payer playbook captured, and the specialists trained to 80 to 90% ready before touching live work. A floater trained alongside them at no cost to the group.
Onboarding call · transcriptanonymized
S
Staffingly
First week is pretty much setup and our internal trainings to make sure they’re at least 80, 90% ready before they go live. Each practice’s workflows are different, so we need to know exactly what we’re looking at.
PR
Practice
How do we know it’s actually working and not just quiet?
S
Staffingly
We do a weekly 15-minute standup call just to make sure everything is going well. You see every renewal in the queue. If you don’t like the staff member, unlimited replacements. It doesn’t usually happen that way, but if that’s a requirement, we handle it.
What onboarding actually covered. The team learned the group’s payer mix and each payer’s documented reauthorization requirements. They learned the group’s documentation standards, which clinician signs what, and what a complete renewal packet looks like for each plan. They built the consolidated queue inside the group’s own system, imported every active authorization from the per-location spreadsheets, and verified expiry dates line by line, because a queue built on bad dates is worse than no queue at all.
By the end of the week the group had something it had never had: one screen showing every authorization, every expiry, and every renewal already in motion. The spreadsheets were still there, untouched, as a safety net. They would not survive the month.
Chapter 4
Going live: the pilot
Answer first
Week two the team went live under the two-week risk-free pilot, working the queue oldest expiry first. Renewals started going out ahead of payer deadlines instead of after denials, and the per-location spreadsheets were retired.
- Day 1 liveThe queue opened with every soon-to-expire authorization at the top. The team started with the renewals already inside their payer lead-time windows, the ones that could still be saved.
- First standupThe 15-minute weekly call reviewed every renewal in flight. The group’s operations lead saw the full picture across locations for the first time in one view.
- The backlog turnsBy the end of the pilot the renewal queue was current: nothing in it was past its start-by date. New authorizations entered the queue the day they were issued, with units logged against each plan.
- Spreadsheets retiredWith every location’s authorizations living in one tracked queue, the per-office spreadsheets were archived. Nobody asked to keep them.
- Decision pointDay 14, the go or no-go review. The group converted from pilot to the standard engagement without changes.
Nothing in the pilot was magic, and that is the point of this journal. It’s really the same process, just that dedicated staff take care of it, start it on time, and never put it down.
Chapter 5 · Current
Where it stands today
Answer first
The engagement runs today as a steady operation: dedicated specialists on the consolidated queue, a trained floater behind them, renewals starting ahead of every payer deadline, units tracked per client, and a 15-minute standup each week. As the group adds locations, each new site’s authorizations fold into the same queue during onboarding.
The operating rhythm now. Every active authorization across the group lives in one queue sorted by expiry. Each payer has a lead-time rule, so renewal work begins before the deadline that payer enforces, not after a denial announces it. Units are tracked against each client’s covered allowance, which keeps scheduling honest and keeps delivered hours billable. When the assigned specialist is out, the floater steps in the same day. The weekly standup is the only recurring meeting the relationship needs.
What changed for the group. Growth stopped being an authorization problem. New locations onboard into a system that already exists instead of spawning a new spreadsheet. The front-office staff who used to chase renewals between check-ins gave that work up entirely, and the clinical team schedules against authorizations they can trust. The engagement continues on the standard flat weekly fee, and this book grows with it: new entries are added as the work happens.
About this engagement
| Shelf | Memoir (delivered engagement) |
| Specialty | Multi-site ABA / autism therapy |
| Services | Reauthorization tracking, units tracking, denial prevention, payer follow up |
| Model | Dedicated full-time specialists + trained floater, $399 flat per week each |
| Compliance | BAA from day one, HIPAA-trained staff, SOC 2 Type 2, $5M cyber liability |
| Systems | The group’s own EHR and tracking, role-based access, nothing stored on Staffingly systems |
| Status | Active and growing. Entries added as the engagement continues. |
