Staying at an ABA agency vs. going independent as an Idaho CHIS provider
At an agency you're paid hourly ($20–25 an hour is common), the agency holds the Medicaid enrollment, handles the paperwork and insurance, and assigns your clients — and gives you supervision, training and coworkers. Independent, you enroll with Idaho Medicaid yourself, bill directly, carry your own insurance, and find your own clients, with none of that support built in.
How does pay compare?
Agency BIs in Idaho are commonly paid $20–25 an hour while the agency bills Medicaid for the session. As an independent provider you bill Idaho Medicaid directly at the CHIS rate, and you also carry the costs the agency used to cover.
At an agency
$20–25 an hour is common. The agency bills Medicaid for each session and keeps the difference — that difference is what pays for the supervision, admin and insurance you get without thinking about it.
Independent
You bill Idaho Medicaid directly at the current CHIS rate and keep it. Out of it comes what the agency used to absorb: insurance, unpaid admin time, and the gaps between clients.
Who supervises, trains and coaches you?
An agency builds supervision, training and coaching into the job. Independent providers in Idaho get none of that with their registration — nobody is assigned to you, and you have to go find it yourself.
At an agency
Supervision, training and coaching come with the job. Someone reviews your work, and someone tells you what to do when a case gets hard.
Independent
Nothing comes with the registration. No supervisor, no training calendar, no one to ask. This is the part most people underestimate before they leave.
Who handles the paperwork?
At an agency the paperwork is session notes and timesheets. Independent, you enroll yourself before you can bill: a background check, your NPI, the Medicaid application through a Trading Partner Account, a separate review of your degree and hours, and Telligen registration. Then more forms for every client you onboard.
At an agency
The agency holds the Medicaid enrollment. Your paperwork is session notes and a timesheet.
Independent
Several separate systems, all yours: the background check, the Medicaid application (provider agreement, W-9, EFT agreement), the Children's DD review of your degree and hours, and Telligen for prior authorizations. Each has its own portal and its own way of bouncing. After approval, every client means more forms: the Physician/Healthcare Professional Order Form, the Optional Service Forms, and whatever the caseworker needs from you.
What about insurance?
Agency employees are covered under the agency's policy. Independent providers carry their own, and the state requires general liability. Its enrollment instructions say plainly that a professional liability policy does not meet the requirement.
At an agency
You're covered under the agency's policy. Most BIs never see it.
Independent
You carry your own general liability policy and upload proof with your Medicaid application. Professional liability is a different policy and doesn't count.
Where do clients come from?
At an agency, clients are assigned to you. Independent, you find them, and each one starts with a pediatrician's office signing a Physician/Healthcare Professional Order Form and a caseworker receiving paperwork from you that looks the way they expect.
At an agency
Clients are assigned to you. Intake, the physician's order and the caseworker have been handled before you ever meet the family.
Independent
You find them. Each one starts with getting a pediatrician's office to sign the Physician/Healthcare Professional Order Form — and knowing what to do when a week goes by with no response. Then a caseworker needs the right paperwork from you, in a form they recognize.
Who do you talk to when you're stuck?
Agency staff have coworkers and a supervisor down the hall. Independent BIs in Idaho are on their own by default — there hasn't been a place for them to compare notes, which is why Charted runs a free community alongside the walkthrough.
At an agency
Coworkers, a supervisor, someone who has seen your situation before.
Independent
Nobody, by default. That's the gap the Charted Collective's members-only community is built for: independent Idaho BIs comparing notes.
Where to start if you're deciding
Start with the registration process itself. The free walkthrough covers Idaho's own enrollment steps in the state's order, from the background check to Telligen registration, so you can see the whole thing before you decide.
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