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 [verify the current rate before publishing] 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 own three separate state systems before you can bill — a Trading Partner Account, the Gainwell Provider Enrollment Agreement with a W-9, and a background check — and 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
Three separate systems, all yours: a Trading Partner Account, the Gainwell Provider Enrollment Agreement (and W-9), and a background check — each with 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 mistake most people make on the first try is buying general liability when it's professional liability that's needed — the state's own instructions specifically warn about this.
At an agency
You're covered under the agency's policy. Most BIs never see it.
Independent
You carry your own policy, and general liability is not the same thing as professional liability. The state's own instructions specifically warn about this, and it still trips people up on the first try.
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. Charted's free community (on Skool) exists for exactly this — independent Idaho BIs comparing notes. It's free, and it never gates anything paid.
Where to start if you're deciding
Start with the registration process itself. The free walkthrough covers Idaho's own steps — Trading Partner Account, the Gainwell enrollment agreement and W-9, the background check, and the insurance rule — in order, so you can see the whole thing before you decide.
Get the Free Walkthrough