Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Kickbacks

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. People inherently trust their healthcare provider.  You go to your practitioner and expect…

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Posted and filed under Healthcare.

3 Ways to Prevent Physician Burnout

Medscape has been tracking physician burnout and suicide rates through their annual National Physician Burnout, Depression, and Suicide Report. Previous reports of physician burnout suggested that upwards of 50% of clinicians suffer from burnout or excessive work-related stress, afflictions that often lead to a decrease in quality of care for patients, and quality of life…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Diagnostic Testing Done Wrong

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. For those of you who keep up with the latest and greatest in…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Genetic Testing

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. Fraud. It is everywhere; mortgage applications and loans, credit cards, you name it….

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Posted and filed under Healthcare.

What is the Healthcare Equality Index?

The Healthcare Equality Index (HEI) is the Human Rights Campaign’s national benchmarking tool used to evaluate healthcare facilities, their policies, and practices as they relate to the fair and equal treatment of LGBTQ patients, visitors, and employees. Since its conception, the HEI has encouraged and educated healthcare facilities across the United States to adopt LGBTQ-inclusive…

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Posted and filed under Healthcare, Payers.

HEDIS Season: The Home Stretch

As we approach the month of June, we also begin our downward slide towards the end of HEDIS season. HEDIS season, in all its glory, stretches through about 3 calendar seasons – and requires hard work from providers, chart reviewers, and record collection companies from December through October – depending on program enrollment, measures, and…

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Posted and filed under Compliance, Healthcare.

OIG Medi-Cal Audit Reveals $70M in Incorrect Payments

Earlier this month, the Office of Inspector General released a 29-page audit report of an investigation conducted on the California Department of Health Care Services. The audit, which covered the review of more than 112,000 Medicaid capitation payments amounting to nearly $74 million dollars was initiated to determine whether California had made capitation payments on…

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Posted and filed under Healthcare.

The Healthcare Affordability Problem

When it comes to paying for healthcare, Sophie’s Choice becomes Everyman’s Choice. Would you rather feed your family or get that questionable mole biopsied? These are the types of questions otherwise well-adjusted families are forced to make on a regular basis. A recent Kaiser Family Foundation report revealed that the state of healthcare affordability is…

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Posted and filed under Healthcare, ICD-10, Payers.

UnitedHealthcare & AMA Join Forces To Improve Healthcare Accessibility

UnitedHealthcare and the American Medical Association have partnered up to take the next step towards a patient-centric healthcare system. Earlier this month, the organizations announced their intent to propose a collection of 23 new ICD-10 codes associated with social determinants of health (SDoH). This collaboration is just one of many initiatives fronted by UnitedHealthcare and…

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

What Do You Hate Most About Healthcare?

Last night, Advize Health had the opportunity to present before one of the largest chapters of its kind in the United States. The audience, comprised largely of credentialed medical coders and billers who assemble to discuss their professional and issues within the industry, were given the opportunity to explore healthcare fraud from two different perspective….

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