RCM Insights from ABA Billing Expert, Olivia Alwine

With more than 15 years in medical billing and a specialized focus on ABA since 2018, Olivia Alwine brings unmatched expertise and heart to revenue cycle operations. In this spotlight, we explore what drives her, the lessons she’s learned, and what excites her most about the future of billing.

What first drew you to medical billing, and what has kept you passionate about it for over 15 years?

My mom was a medical biller and thought that I had the talent for it! She helped me get a position at the Durable Medical Equipment company where she worked, and I quickly found that billing just clicked for me. I’m a problem solver by nature, and in the world of medical billing, there’s no shortage of problems to be solved. Realizing how much of an impact a caring biller can have on an organization and its patients has kept me passionate about this field. It’s a way for me to help others behind the scenes, and it brings me a sense of accomplishment.

What led you to specialize in ABA billing, and how has that niche shaped your approach to revenue cycle operations?

My journey into the ABA billing world actually started with personal health problems that led me to look for a work-from-home position. I came across a job opening with a remote ABA billing company, where I was hired and worked for five wonderful years. From there, I spent two exciting years at an ABA clinic based in Texas and Nebraska.

The experience I gained in both settings gave me a well-rounded understanding of ABA practices—from the patient intake process to staffing challenges and scaling operations. It allows me to connect the dots between all these areas and revenue cycle operations, and to see how the work my team and I do supports so many facets of the business.

How do your values of compassion, honesty, and loyalty influence your work and leadership style?

I do my best to live by the golden rule—treat others the way you want to be treated—and I think that goes a long way in fostering and maintaining relationships. When I work with a client and they know that I truly care about them personally, about their business, and about their patients, that’s priceless.

My clients know they can depend on me because I care. I care that they have correct claims being sent to the payer. I care that they understand their financial situation. And I care about their goals for growing their business so they can serve more patients.

Without a caring biller on their side, they’re going to hit roadblocks that delay their impact on the autism community. That care naturally translates into compassion, honesty, and loyalty—values that also guide how I interact with my team and colleagues. My goal each day is to lead with these qualities and foster an environment where my team feels empowered and trusted.

What have been some of the biggest shifts in compliance or payer requirements you’ve had to navigate?

One of the biggest shifts I’ve experienced was the transition from temporary codes (Category III) used for ABA therapy to the current code set (Category I). It was a huge step forward but required intense organization and attention to detail. We had to verify which code set each payer was using, as not all funders made the switch—and some still haven’t.

There have also been several changes in session note requirements, where we need to ensure all required information is properly documented and relayed to the funder. Compliance and payer requirements are constantly evolving, so staying up to date is a daily effort.

Are there any common billing challenges in ABA that you’re especially passionate about solving?

A common disconnect I come across in ABA is the lack of understanding around how various parts of the business directly impact RCM. For example, if contracting and credentialing aren’t properly completed and maintained, it can delay claims and affect reimbursement amounts. Similarly, if thorough benefit checks aren’t done when a family first expresses interest in services, denials may occur due to funder limits—jeopardizing care for the patient.

Educating providers and business owners about RCM is a passion of mine because it’s such a critical part of helping them scale and serve more kids.

What excites you most about the future of billing and revenue cycle management?

Honestly, I’m really excited about advances in technology. As tech improves, it frees up billers to focus on the more complex issues—like strange funder denials—where human brains are still essential.

I’m especially excited to be working at Lumary, alongside our amazing team, to continually improve our product—especially when it comes to the billing side.

Want to connect or learn more? Reach out to Olivia on LinkedIn, or request a demo to see how Lumary’s ABA billing solutions can support your team.