The Challenge: Drowning in Admin and Starving for Cash Flow
When Sarah Miller, BCBA, launched her own ABA practice, she had a simple dream: do meaningful work with clients, build a values-driven team, and run her practice on her terms.
But reality hit fast.
“I was spending more time on hold with insurance companies than actually supervising therapy,” Sarah recalls. “Credentialing, billing, scheduling, prior authorizations—it all landed on me. I was burning out before I’d even gotten my second client.”
Like many new ABA entrepreneurs, Sarah faced a painful paradox. Her clinical hours were growing, but so were the administrative headaches. And the real killer? Cash flow.
“I had staff to pay every two weeks, but insurance wasn’t reimbursing me for 6 to 8 weeks. I was fronting thousands of dollars I didn’t have. It was terrifying.”
The emotional toll started to stack up. Missed invoices, panicked staff texts about delayed paychecks, a half-built spreadsheet system that made payroll a guessing game.
“I didn’t start my practice to become a full-time admin assistant. I just wanted to serve families well—and keep the lights on.”
The Breakthrough: A Better Way Forward
It wasn’t until she attended the “You’ve Started a Practice… Now What?” webinar that things began to shift.
“I heard Michael talk about cash flow—how practices crash not because they don’t have clients, but because they don’t have systems. I was like, ‘That’s me. That’s exactly me.’”
What stood out wasn’t just the software—it was the empathy.
“Most platforms sell you features. Alpaca talked about freedom. About letting clinicians actually be clinicians again.”
Sarah signed up for a 1:1 call and quickly realized this wasn’t just another EHR or billing tool—it was an operating system for her business.
The Solution: Admin-Free Growth, Powered by Alpaca
From day one, Alpaca took over the administrative lift.
“They handled my credentialing, billing, scheduling, eligibility checks, all of it. I went from 10 hours a week of admin to almost none.”
More importantly, Alpaca solved Sarah’s cash flow crisis.
“Instead of waiting 2 months for insurance, they paid me every 2 weeks. Like clockwork. That changed everything. I could plan, hire, grow.”
Through Alpaca’s model, Sarah credentialed under their group contracts, allowing Alpaca to bill directly and pay her biweekly from the expected reimbursements—shouldering the financial risk so she didn’t have to.
“They paid me before they got paid by insurance. No one else does that.”
Scheduling got easier too. With Alpaca’s AI-powered rescheduler, session cancellations no longer derailed her team’s caseload.
“If a BT or parent needed to reschedule, the AI handled it—texted both sides, offered new times, and logged it all. I didn't even have to be involved unless I wanted to.”
And because it was all on one platform—scheduling, billing, payroll, texting—there were no spreadsheets, no double entry, no guesswork.
“I haven’t used a Google Sheet for payroll in months. That alone feels like a miracle.”
The Results: Predictable Cash Flow, Happy Staff, and Clinical Focus Restored
Six months later, Sarah’s practice had tripled in size—from 2 clients to 7, and from 1 BT to 5.
“I finally have time to think big again,” she says. “We’re training a clinical lead, launching a parent coaching group, and I just spent my first full Friday off in a year.”
Her staff feels the shift too.
“Getting paid on time builds trust. It creates stability. And with the AI doing reschedules, they’re not losing hours anymore.”
Client families noticed it as well.
“They love the parent portal. They can message us, view sessions, even pay their copays online. It’s simple, respectful, and actually helpful.”
Most of all, Sarah is back to doing the work she loves—without drowning in logistics.
“I get to be a BCBA again. Not a billing specialist. Not a tech support rep. Just a clinician.”
The Innovation: A Full-Service Operating System for Clinician-Owned Practices
What makes Sarah’s story unique isn’t just her rapid growth—it’s how intentionally she grew.
Instead of scaling with chaos, she scaled with infrastructure.
Alpaca didn’t just give her a dashboard—they became a partner with skin in the game. Their biweekly payments only work if insurance actually reimburses, which means Alpaca is deeply invested in clean, compliant, successful billing.
“It’s the first time I’ve worked with a vendor who’s actually aligned with my outcomes.”
And because Alpaca isn’t just software—it’s software plus services—Sarah didn’t have to hire a separate intake coordinator, billing manager, or scheduling assistant.
“I saved at least two hires just by using Alpaca.”
The Tools & Technology: Why It Works
All-in-One AI EHR: Scheduling, data collection, and session notes in one place
Biweekly Provider Payments: Fast, predictable income even when insurance is delayed
Integrated Parent Portal: Messaging, session visibility, and payment in one app
AI Rescheduler: Intelligent, automated session coordination with BTs and parents
End-to-End Admin Services: Credentialing, billing, verification, prior auth, payroll
Texting Built In: HIPAA-compliant family communication via SMS
Looking Ahead: Scaling with Purpose
Next on Sarah’s roadmap?
“I want to double our caseload—but only if we can keep quality high. With Alpaca, I know we can grow and stay grounded in clinical excellence.”
She’s also mentoring other BCBAs who want to go independent.
“So many of us are burned out by the corporate chains. Alpaca gives us a real shot to build something better.”
Advice to Others: Build with Systems, Not Spreadsheets
When asked what she’d tell new or struggling ABA practice owners, Sarah doesn’t hesitate.
“Don’t try to do it all yourself. That’s how you burn out, or worse, burn your practice down.”
She continues:
“Find partners who actually care about your success. Not just tech vendors. Alpaca isn’t selling software—they’re building freedom for clinicians.”
And for Sarah, that freedom made all the difference.
Book a demo with Alpaca today!
