For many Ohio providers, an ODM billing audit feels like something that happens to other organizations—until the letter arrives. In reality, billing audits from the Ohio Department of Medicaid are a routine part of today’s Medicaid environment. And while you can’t...
Many developmental disabilities (DD) providers feel financially stretched even when services are full, staff are working hard, and demand is strong. When revenue doesn’t match effort, the problem is often revenue leakage. Revenue leakage in DD services isn’t usually...
If it feels like Ohio Medicaid claim denials are becoming more frequent, you’re not imagining it. Across Ohio, developmental disabilities and human services providers are seeing a noticeable rise in denied Medicaid claims. And while denials used to be driven mostly by...
In late 2025, Ohio took a major step in tightening its Electronic Visit Verification (EVV) requirements for Medicaid-reimbursed services—and the ripple effects are just beginning to be felt across the home- and community-based services (HCBS) sector. Effective October...
If you’re an Ohio provider, you already know that Medicaid billing in 2025 has been anything but simple. With evolving Electronic Visit Verification (EVV) requirements, tighter claims validation, and new denial enforcement, mistakes that were once minor now cost...
