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

Fraud Spotlight: Compliance & The Reluctant Provider

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. Every compliance professional hopes that their employer buys into the suggestions, recommendations and…

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Posted and filed under Careers, Coding, Community.

Celebrating National Medical Coder Day

May 23rd  is  National Medical Coder Day to celebrate YOU and your unrelenting dedication to the field and endless hard work.  From educating providers to helping keep protected health information safe and secure — YOU are a compliance warrior!  YOU are an essential front line worker! Do you feel like you aren’t treated as such? We’re…

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

Fraud Spotlight: Document Now, Ace an Audit Later

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. Every day, we read another article or another news release about the ever-changing…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Telehealth & the Medicare Population

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. Over the past several weeks, we have seen unprecedented changes to rules, edits…

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Posted and filed under Fraud, FWA.

Fraud Spotlight: Chronic Care Management Fraud

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. Recently, I was speaking with a client regarding Chronic Care Management (CCM), and…

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Posted and filed under Community, Compliance, Fraud.

5 Common COVID-19 Fraud Schemes

Relaxed Doesn’t Mean Right …and it certainly doesn’t imply safe. First, we are seeing it with Cybersecurity. Then, we will see more leniency with HIPAA and FWA around the practices and procedures that are occurring. We have seen unprecedented allowances in the past two months. CMS is relaxing the rules, telehealth is being set up to work…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Provider Credentials, Fraud, & COVID-19

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 From a resource perspective, we as a nation, and those in the law…

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

Fraud Spotlight: Advance Directives Prevent Healthcare Fraud

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. I’m going to preface this by saying what I’m about to write about…

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Posted and filed under Community, Healthcare, Technology.

Healthcare Heroes: Industry Disrupters

A pandemic is wreaking havoc across the globe. The healthcare system is layered in bureaucracy that stagnates progress and stonewalls idealism. Sometimes, it seems like the fight is futile…but it’s not. What healthcare needs is a disrupter (or disruptor, depending on your preference), and lucky for us, there are already several making waves in the…

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