A Month Without a Paycheck: When the Insurer Stops Paying

Imagine showing up for the same kid every day for five years. Then a month goes by with no paycheck.

That's exactly what one Florida RBT described to CBS Miami. According to her agency, most of its Medicaid claims haven't been processed since October 1, when Florida's Medicaid program for children with special healthcare needs transitioned to a new insurance provider.

And her agency may not be alone. A Florida attorney told CBS Miami that nearly 700 providers he's spoken with reported similar payment problems, although that number hasn't been independently verified. Florida's Medicaid agency says it's investigating the issue.

What was promised

Breaking News ABA reports the state told providers back in April that the new plan would pay promptly, honor existing approvals and let kids keep their current providers for up to about eight months. The new insurer took over coverage for approximately 115,000 members and, despite reports of payment delays, told investors on October 22 that the transition was going well.

This isn't new

A Florida tech posted on r/ABA about two years ago that their company warned of payroll delays tied to Medicaid plan changes, and asked staff to sign an agreement about it.

When an insurer stalls, the clinic waits. And too often, the tech waits too.

Questions to ask before you sign

• How much of the clinic's business depends on one insurance provider?
• Has the company ever experienced payroll delays?
• If insurance reimbursements are delayed, how does the company ensure employees are still paid on time?
• Is compensation based on completed sessions or a guaranteed salary?

You don't need a clinic's bank statements. You do need a straight answer.

Our matchmakers ask these before you ever get on a call. Want a clinic with a plan for the bad months? Find us at u/PairABA.

News recap only, not legal or billing advice.