The number in your system is not the number you can bill
A payer approves 100 hours a week. The family will do 20. Your forecast still says 100, because 100 is the number the system shows you.
Three different numbers get treated as one in most ABA practices, and only the third one turns into money.
Authorized hours are what the payer will allow. The reservoir is what the guardian has actually agreed to and the analyst has actually approved. Delivered hours are what happened.
Revenue comes from the third number. Almost every forecast gets built on the first.
What a reservoir is
An authorization is the size of the tank the payer will let you fill. It is not water. The reservoir is the water actually in it — the hours a specific client will realistically receive.
Two gates narrow the authorization down to the reservoir, and both of them sit outside the payer's control.
The guardian. A family agrees to a schedule that fits their life. Authorized for 100, available for 20, reservoir is 20. The other 80 hours are a number in a system that nobody is going to deliver.
The analyst. Clinical judgment about what this client can tolerate and what the treatment plan actually calls for. Sometimes that lands below what the guardian would accept.
The reservoir is the lowest of the three. Not the average, not the authorization. The lowest.
Owners already run this way. You staff to what the client needs, not to the authorization. The reservoir is simply that judgment written down, per client, where a forecast can use it.
The gap you cannot recover, and the one you can
Worth being precise here, because these two get collapsed and they behave completely differently.
The gap between authorized and reservoir is not a loss. That money was never yours. Nobody is going to recover it, and treating it as recoverable is how a practice ends up budgeting against revenue that was never coming.
The gap between reservoir and delivered is the real one. Those are hours a family agreed to, an analyst approved, and a payer will pay for — that did not happen.
And then there is burn: sessions delivered against an authorization that is exhausted, expired, or was never right in the first place. The clinician worked. The family got the service. You paid the tech. None of it can be billed, and there is no appeal, because the problem is not the claim.
Burn is the most expensive leak in ABA for one reason. The cost is fully incurred before anyone discovers the revenue is not there.
What the arithmetic looks like
Round numbers, so the shape is visible. A practice with 40 active clients, a blended rate of $75 an hour.
Illustrative arithmetic, not a client engagement.
Forecast on the authorization and you are planning against $90,000 a week. You will collect $45,000. That is a 50 percent miss, and over a month it is roughly $195,000 of revenue that was never going to arrive.
Forecast on the reservoir and you are planning against $54,000. You collect $45,000. The miss is $9,000 a week, and every dollar of it is a session that a family agreed to and did not get.
Same practice. Same week. One number is a forecast you can staff against and one is a story.
Now add the burn
Say 2 percent of delivered hours land outside a valid authorization. On 600 hours a week that is 12 hours.
12 hours × $75 = $900 a week. Call it $47,000 a year of clinical work delivered at full cost with no revenue attached to it.
That number does not appear anywhere in your collections report, because no claim was ever created. It shows up as payroll. It is the reason a practice can look busy, look fully authorized, and still run tight on a Friday.
The one leak you close by delivering more care
Every other stage on the Leak Map is about recovering money that got away — a claim that denied, a payment that never posted, a rate loaded wrong.
This one is different. You close the reservoir-to-delivered gap by delivering more of the care a family already agreed to. Nobody has to call a payer. Nothing has to be appealed. The fix and the mission point in the same direction, which is not something you get to say very often in revenue cycle work.
Five checks you can run this week
You do not need anybody's help for these. Start with your ten largest clients by authorized hours.
1. Build the reservoir. Three columns per client: authorized hours, hours the guardian has agreed to, hours the analyst has approved. Take the lowest of the three. That is the reservoir. Total the column.
2. Compare reservoir to scheduled. If scheduled is below the reservoir, you have capacity a family already said yes to and nobody put on the calendar.
3. Compare scheduled to delivered. The difference is cancellations, which is stage 02 and its own conversation — but you cannot see it clearly until you have the reservoir underneath it.
4. Pull every authorization expiring in the next 90 days. Sort by date. Anything inside 30 days without a renewal in motion is a session about to be delivered against nothing.
5. Units remaining against weeks remaining. For every active authorization, divide units left by weeks left. If the weekly run rate is above that, the authorization runs out early and everything after that date is burn.
Check five is the one that catches the expensive failure before it happens instead of after.
The number to actually track
Reservoir utilization. Delivered hours divided by reservoir hours. Healthy is somewhere north of 85 percent.
Authorization utilization — delivered divided by authorized — is a vanity metric. It will always look bad, it will never be actionable, and chasing it pushes clinicians toward hours the family never wanted.
Where this sits
This is the first of seven stages where ABA revenue leaves, and it is the furthest upstream. A Leak Map Assessment measures all seven — from the reservoir through cancellations, session conversion, biller lag, clean claims, rate integrity and recoupments.
A claims audit is a different instrument. It starts at stage four, after a session has been converted and billed, and reconciles the back half of the cycle to cash. It is the right tool when you already know which payer book is the problem.
In most practices the larger number is upstream, before a claim exists to audit.
Aimline closes the books, oversees the revenue cycle, and sits in the CFO seat for ABA practices. We run claims audits scoped to a payer book, and Leak Map Assessments that measure the full cycle — three weeks, $7,500 fixed. Either one gives us a verified number to run oversight against, and the report is yours whether or not you engage us to fix what it finds.
