Category Archives: iMAX Medical Billing Insights

Avoiding the Wide Net of Fraud Conspiracy Investigation

Protecting your company from a potential exposure, whether on the civil or criminal end, from the outside or from insiders, requires dedication to compliance. The word is out. There is money to be made in healthcare fraud—and not just in schemes by providers to steal payor funds, but by the government under federal and state statutes busting fraudulent conduct. How an action starts is really quite simple: maybe a former patient or employee reports a provider, or maybe a provider is just such a high utilizer of services that the conduct is brought to the attention of an oversight agency.

‘Incredible loss of life’ to overdoses

Over seven years, Hancock County lost nearly 2,000 years of life expectancy because of opioid overdoses, and Ohio lost more than half a million years. Those figures are among the findings of a recent report by the Ohio Alliance for Innovation in Population Health, a collaboration between Ohio University’s College of Health Sciences and Professions and the University of Toledo’s College of Health and Human Services. Statewide, 13,059 Ohioans died from opioid overdoses from 2010 to 2016, and those overdoses accounted for 519,471 years of life lost. “This figure represents over half a million years of life lost to Ohioans

How can we build social support for people in recovery?

When we asked Ohioans to share what they saw as causes of the addiction crisis, many cited boredom, lack of activities, and peer pressure. Even after undergoing treatment for substance use disorder, people face the possibility of falling back into the same toxic routine and friendships they had before seeking help. According to the Substance Abuse and Mental Health Services Administration, recovery will be most successful if people have a safe, comfortable, and secure home, meaningful activities to do such as working, going to school, and volunteering, and a strong community of people that offer encouragement along their journey. On

Lorain Drug Rehab Facility Expanding Due To Ohio Medicaid Reorganization

With demand for drug treatment soaring due to the opioid epidemic, addiction service providers are looking for ways to get people who want help off waiting lists and into their facilities. For years, the federal Centers for Medicare and Medicaid Services (CMS) – the agency that pays the bills for many people in rehab – has prohibited the use of federal dollars for addiction treatment in facilities with more than16 beds. Ideastream’s Be Well health reporter Marlene Harris-Taylor and ideas host Rick Jackson had a conversation about how things are changing around the 16-bed rule specifically for rehab facilities in

Fentanyl use drove drug overdose deaths to a record high in 2017, CDC estimates

Drug overdose deaths surpassed 72,000 in 2017, according to provisional estimates recently released by the Centers for Disease Control and Prevention. That represents an increase of more than 6,000 deaths, or 9.5 percent, over the estimate for the previous 12-month period. That staggering sum works out to about 200 drug overdose deaths every single day, or one every eight minutes. The increase was driven primarily by a continued surge in deaths involving synthetic opioids, a category that includes fentanyl. There were nearly 30,000 deaths involving those drugs in 2017, according to the preliminary data, an increase of more than 9,000 over the

Cheaper, purer meth piggybacks opioid crisis in Ohio

PIKETON, Ohio – Richard Kreager is quick to share his most embarrassing photos: The one where he is handcuffed on the side of the road, surrounded by police officers, or the shot of him lying in a hospital bed, hooked to a ventilator, his kidneys shutting down. Each, he says, serves as a cautionary tale of his addiction to methamphetamine. “They say one time is too many, and 10,000 times are never enough,” said Kreager, 35, of Dublin, who has been in a southern Ohio recovery program since the spring. “It’s just as bad as heroin.” In Ohio, the number

Healthcare Claims Management Market to Reach $13.9B by 2023

Increasing patient volumes and declining reimbursement rates will drive providers and payers to seek healthcare claims management solutions by 2023. The global healthcare claims management market is slated to reach $13.93 billion by 2023, up from a valuation of $10.16 billion in 2017, MarketsandMarkets recently reported. The significant projected growth in the healthcare claims management market equates to a 5.3 percent compound annual growth rate (CAGR) during the forecast period. “The key factors driving the growth of this market are increasing patient volumes, expanding health insurance market, growing importance of denials management, and declining reimbursement rates,” explained the market research organization.

Drug courts key in opioid fight

In the big, complex world of Ohio’s opioid problems, drug courts may only be a small part of the solution. But they are an important component, nonetheless, and Hancock County is fortunate to have one in place in common pleas court. The need has never been greater for a program that provides certain low-level, nonviolent drug offenders the tools they need to become functioning citizens instead of convicted felons. The first drug court here began in 2014 under the oversight of Judge Reg Routson, and the second is now run by Judge Jonathan Starn. The first two graduates from Starn’s

Recent spike in overdoses in Montgomery County

MONTGOMERY COUNTY, Ohio (WDTN) – The Montgomery County Alcohol, Drug Addiction and Mental Health Services (ADAMHS) released a statement today that said while deaths are down from last year, recently there has been a dramatic spike in overdoses. Montgomery County is one of seven counties in Ohio that the Ohio Department of Health has seen an increase in drug overdose patients in emergency departments. The Montgomery County coroner’s office said that while heroin is the dominant drug they are seeing in these overdoses, methamphetamine is making a resurgence, and they want to remind everyone the dangers of opioids or meth being laced with

A New Wave Of Meth Overloads Communities Struggling With Opioids

Principal Mary Ann Hale dreads weekends. By the time Fridays roll around, 74-year-old Hale, a principal at West Elementary School in McArthur, Ohio, is overcome with worry, wondering whether her students will survive the couple of days away from school. Too many children in this part of Ohio’s Appalachian country live in unstable homes with a parent facing addiction. For years, the community has struggled with opioids. Ohio had the second-highest number of drug overdose deaths per capita in 2016, according to the Centers for Disease Control and Prevention. But in McArthur, a close-knit village of about 2,000 in rural