OGDEN, UT— Most people who end up shaping a niche industry don’t set out to do it. Michele Silcox-Beal set out to be a good accountant. She was. And then she walked into Trumpet Behavioral Health, encountered the billing labyrinth that every ABA provider navigates alone, and realized that two decades of accounting expertise — across hospitals, construction firms, and corporate back offices — had quietly prepared her for a problem the ABA field didn’t know it was about to have.

Today, Silcox-Beal is the Executive Vice President of Revenue Cycle Management at Bierman Autism Centers, one of the largest multi-state ABA providers in the country, with locations across Arizona, Indiana, Massachusetts, New Jersey, North Carolina, Ohio, and Rhode Island. She arrived there after a journey that included building and selling one of the field’s first dedicated ABA billing firms, leading RCM quality at the company that acquired it, and co-authoring the textbook that now sits on the shelf of virtually every serious ABA billing professional in the country.

“Nearly a decade ago, I recognized the challenges ABA providers were facing balancing a growing number of patients with administrative tasks like billing and reimbursement, and staying compliant with ever-changing regulations.”
— Michele Silcox-Beal

The arc of her career is not a straight line. It is, in retrospect, an accumulation — each role adding a layer of technical and operational depth that made the next thing she built more durable than it would have been otherwise.

Twenty Years of Ledgers, and Then: Behavioral Health

Silcox-Beal holds an Associate of Arts from American InterContinental University and built her professional foundation through more than two decades of accounting work across multiple industries. She learned early that the core principles of accounting — internal controls, reconciliation, team management, back-office systems — translated across sectors in ways that specialists within a single industry often failed to see. That cross-industry perspective would become one of her most durable professional assets.

Her entry into behavioral health came through Trumpet Behavioral Health, where she served as Manager of Accounting. It was her first sustained encounter with the operational back end of an ABA organization — and with the specific complexity of ABA billing. Unlike general medical billing, ABA reimbursement involves session-level documentation requirements, authorization management tied to individualized treatment plans, credentialing timelines that can delay revenue by months, and payer-specific rules that vary dramatically across states and insurance carriers. The field was growing fast in the early 2010s, pushed by state insurance mandate legislation that was sweeping the country. The administrative infrastructure was not keeping pace.

Silcox-Beal saw the gap clearly: ABA providers needed billing support from people who understood the clinical structure of the work, not just general medical coding. And almost no one was offering it at scale.

Abab: Building the First Dedicated ABA Billing Firm

ABA Therapy Billing and Insurance Services — known in the field as ABAB — was among the very first companies in the country to offer revenue cycle management services built specifically for ABA providers. Silcox-Beal launched it with a comprehensive service model: benefit and authorization management, claims management, network participation management, provider credentialing and contracting, intake support, and RCM consulting and training.

Practices could outsource the entire revenue cycle to ABAB’s team, receive training to manage it in-house, or engage Silcox-Beal’s parallel consulting practice, MKS Consulting LLC, for auditing and practice management reviews.

The consulting arm was particularly distinctive. Under the MKS banner, Silcox-Beal offered Health of Account Audits — comprehensive reviews of a practice’s billing health and revenue cycle integrity — alongside session notes audits and credentialing consultations. For a field that was simultaneously navigating rapid growth, increased payer scrutiny, and new compliance requirements, these services addressed real operational risk. Underbilling, authorization lapses, and documentation deficiencies were all common failure points. Silcox-Beal built tools to find them before payers did.

Over roughly a decade, ABAB grew into a nationally recognized operation. The company’s client base expanded across states, and its reputation for deep ABA-specific expertise — rather than generic medical billing — distinguished it in a market that was beginning to see competitors emerge. Silcox-Beal was also a visible presence at industry conferences during this period, presenting on billing and compliance topics for organizations including the Association for Professional Behavior Analysts (APBA), where she spoke at the Leadership Conference.

The Cape Cod Collaboration and the Textbook That Followed

Among the projects Silcox-Beal undertook during the ABAB years, the one with the longest reach may be the simplest to describe: she sat down with co-author Sarah Schmitz and wrote the book. Titled Revenue Cycle Management for Applied Behavior Analysis ABA Therapy and now in its second edition, it is a field-wide guide to the full revenue cycle — from credentialing and contracting with funding sources through patient intake, billing, claims management, and audit preparation. The volume covers organizational structure, team roles, ethical standards, practice management software evaluation, and the specific mechanics of navigating both in-network and out-of-network billing relationships.

The collaboration between Silcox-Beal and Schmitz — informally called the Cape Cod Collaboration — produced a resource that the field had been missing. Before the book, ABA billing knowledge was largely tribal: passed between colleagues, accumulated through trial and error, and siloed in individual practices. A structured, publicly available guide to the full revenue cycle gave new billing staff a foundation to work from and gave practice owners a common framework for evaluating their own operations. The second edition updated and expanded the original to reflect changes in payer contracting, technology platforms, and compliance requirements that had evolved significantly since the first publication.

Acquisition, and the Move to Enterprise Scale

In October 2023, RethinkFirst — the leading SaaS and solutions provider in behavioral health — acquired ABA Therapy Billing and Insurance Services. The deal was announced as part of RethinkFirst’s strategy to expand the managed services capabilities of its RethinkBH practice management platform, which serves ABA and pediatric therapy providers ranging from startups to multi-site enterprises. Silcox-Beal joined RethinkFirst as Vice President of Revenue Cycle Management Quality, bringing ABAB’s team and operational infrastructure inside one of the field’s most widely used software ecosystems.

The transition from independent founder to VP at a national SaaS company represented a different kind of challenge: scaling her team’s approach across a platform with thousands of provider clients, standardizing quality in a distributed environment, and integrating ABAB’s methodology into software workflows rather than stand-alone service engagements. It was the kind of problem that her cross-industry accounting background, and a decade of building billing infrastructure from scratch, had positioned her to handle.

Her current role — Executive Vice President of Revenue Cycle Management at Bierman Autism Centers — represents another evolution in that arc. Established in 2006 and now operating across seven states, Bierman is one of the country’s most established multi-site ABA providers, offering ABA therapy, speech therapy, occupational therapy, and diagnostic services. Silcox-Beal oversees RCM across all locations, managing the billing, compliance, credentialing, and payer relationship infrastructure that keeps a large, growing provider organization financially functional.

On the Conference Floor and in the Ethics Conversation

Across her career, Silcox-Beal has maintained an active presence in the field’s conference and professional development ecosystem. She has presented at the APBA Leadership Conference on billing and compliance topics, and has been a recurring presence at events including the Autism Law Summit.

The focus of her speaking work has been consistently practical: how to structure a revenue cycle team, how to identify and correct billing deficiencies before they become audit findings, how to evaluate practice management software against real operational needs.

She is also a member of Dr. Jon Bailey’s ABAEthicsHotline, a resource that supports behavior analysts navigating ethical questions in their practice. Her involvement there — contributing to education for providers on ethical billing practices — reflects a long-standing view that revenue cycle management and clinical ethics are not separate domains. The way a practice bills for services, structures its authorizations, and documents its sessions has direct implications for patient access, treatment continuity, and regulatory integrity.

Her certifications reflect the same commitment to formal mastery. She holds the Certified Professional Medical Auditor (CPMA) designation and the Certified Medical Reimbursement Specialist (CMRS) credential through the American Medical Billing Association — two certifications that are relatively rare in the ABA-specific billing space and that signal technical depth beyond general coding knowledge.

The Infrastructure That Makes Care Possible

The ABA billing landscape Silcox-Beal entered in the early 2010s looked nothing like the one that exists today. Insurance mandate legislation had created demand that providers were scrambling to meet. Payers that had never processed ABA claims were writing authorization policies in real time. The electronic health record ecosystem for behavioral health was fragmented and immature. And the billing workforce that ABA practices needed — people who understood the specific documentation and authorization architecture of the therapy — barely existed as a category.

Silcox-Beal built into that gap at exactly the right moment. ABAB helped establish the category itself: what ABA-specific billing support could look like, what it should include, and what the baseline standards for ethical and compliant practice management were. The textbook codified those standards in a form that the field could carry forward. The conference work disseminated them. The audit consulting caught the deviations before they became crises.The consolidation wave that has reshaped ABA since 2018 — private equity roll-ups, multi-state platform builds, acquisitions like the one that brought ABAB into the RethinkFirst ecosystem — has made the work Silcox-Beal pioneered more important, not less. Larger organizations mean more complex payer portfolios, more locations to credential, more staff to train, and more revenue at risk from billing errors or compliance failures. The infrastructure she spent a decade building from scratch is now the infrastructure that enterprise ABA requires at scale.

Career History
Bierman Autism Centers: Executive VP, Revenue Cycle Management (Current)
RethinkFirst / RethinkBH: VP, Revenue Cycle Management Quality (2023–2025) — joined via ABAB acquisition
ABA Therapy Billing & Insurance Services (ABAB): Founder & CEO — one of the first dedicated ABA billing companies nationally — ababilling.net
MKS Consulting LLC: Founder & CEO — ABA audit consulting, session notes audits, health-of-account reviews
Trumpet Behavioral Health: Manager of Accounting — entry into the ABA space

Published Work
Book (2nd Ed.): Revenue Cycle Management for Applied Behavior Analysis ABA Therapy — co-authored with Sarah Schmitz, CPB-I, CMRS-I — available on Amazon
Book (1st Ed.): Revenue Cycle Management: ABA Therapy — “The Cape Cod Collaboration”

Credentials & Affiliations
Certifications: CPMA (Certified Professional Medical Auditor); CMRS (Certified Medical Reimbursement Specialist, AMBA)
Ethics: Member, Dr. Jon Bailey’s ABAEthicsHotline — abaethicshotline.com
Speaking: APBA Leadership Conference; Autism Law Summit; ABA industry events on billing, compliance, and RCM
Education: Associate of Arts, American InterContinental University