Posted and filed under Dental, Fraud, FWA.

Fraud Spotlight: Why Dental Fraud is Overlooked & Ignored

Over the past few weeks, we have been blogging and posting about the “red-headed step-child” of healthcare fraud, dental fraud. One of our retired OIG agents recently heard this tale, which bears repeating: At a recent visit, his mother was told by the treating dentist that she had a gum infection and needed to see…

Read the full article

Posted and filed under Compliance, Fraud, FWA, Medical Record Auditing.

Fraud Spotlight: Provider Negligence & Ignorance are Non-Compliance

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  For the past few weeks, we have been standing on the soapbox and waving the flag…

Read the full article

Posted and filed under Compliance, FWA, Healthcare, Payers.

Fraud Spotlight: Understanding Medicare as a Secondary Payer (MSP)

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  Recently, we discussed a situation where Medicare may still pay for a service, item or procedure…

Read the full article

Posted and filed under Compliance, Fraud, FWA, Healthcare.

Fraud Spotlight: Invest in Compliance – All Providers Are Audited

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. When determining if a practice should spend the time, effort, and expenses that are associated with…

Read the full article

Posted and filed under Compliance, Fraud, FWA.

Fraud Spotlight: COVID, Cross Fraud & FWA Detection

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. In the past few weeks, there have been some notable prosecutions concerning the on-going frauds associated…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: What We Can Learn From The Novartis Settlement

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. If you are keeping a scorecard on healthcare fraud prosecutions and settlements, you undoubtedly saw that…

Read the full article

Posted and filed under Compliance, Fraud, FWA, Healthcare.

Fraud Spotlight: How Crises Can Impact Fraud Investigations

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. Hurricane Katrina and COVID-19, what do these two very different things have in…

Read the full article

Posted and filed under Compliance, Fraud, FWA, Healthcare.

Fraud Spotlight: How HRSA & The CARES Act Entice Fraudsters

Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. One of the areas of reimbursement that has gotten very little discussion concerning…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Real Healthcare Fraud Profiteers

Healthcare fraud is a pervasive issue, we all know this. We write about its effects every week here at Advize Health, and thousands of our compatriots have dedicated their professional lives to put a stop to the issue – much to no avail. Sadly, it seems that healthcare fraud is here to stay. This is…

Read the full article

Posted and filed under Fraud, FWA, Healthcare.