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

Risky Retrievals

For years, whenever we began launching a medical record review project, clients and physicians alike would ask us the same question: Why can’t you come onsite to pick up the requested records? The easy answer would have been to say that we simply hadn’t performed record retrievals before, but we had vested interest in doing…

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Posted and filed under Compliance, Healthcare, Payers.

The Road to Compliance

The road to compliance is long and bumpy, but a trip we must all take in 2018. In January 2017, compliance professionals from the Department of Health and Human Services (HHS), Office of Inspector General (OIG) held an assembly in which they discussed how to measure the efficacy of Compliance Programs. From this roundtable came…

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Posted and filed under Healthcare, Payers.

Is This The End of CHIP?

The Children’s Health Insurance Program (CHIP) is a program that has managed to gain (mostly) bipartisan support, as it provides low-cost healthcare to children in families that earn too much money to qualify for Medicaid; but its days may be numbered.  The funding for CHIP ended on September 30th, 2017…and unfortunately, Congress has not yet…

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Posted and filed under Compliance, Fraud, FWA.

Don’t Get Ghosted by Your DME Supplier

Medicare fraud maintains its position among the fastest growing crimes in the United States. The government loses nearly $75 billion a year to Medicare fraud; which has led to the conception of several anti-fraud initiatives, including the OIG’s Operation Whack-A-Mole (WAM). Medicare fraud comes in many shapes and forms, with the three most popular including:…

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Posted and filed under Compliance, Healthcare.

Is OurNotes the Future of Documentation?

OurNotes is the name of an experimental, collaborative approach to clinical documentation that encourages providers and patients to co-produce medical notes. Researchers at the University of California, Los Angeles (UCLA) suggest that this kind of participation in the healthcare life cycle will improve overall engagement for patients, while freeing up time for their physicians. Taking…

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Posted and filed under Compliance, Healthcare, Payers.

HHS Retracts Support For Financial Assistance Charity

In an unexpected, albeit responsible move, Health and Human Services has retracted their support for a Patient Assistance Program. The Caring Voice Coalition (CVC) is a patient assistance charity that provides financial support to Medicare beneficiaries and other patients. Found in 2003 with seemingly noble intentions, the CVC was founded in 2003 to support patients…

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

Examining The Fraud Triangle

Federal healthcare fraud recoveries totaled upwards of $2B in the first half 2017’s fiscal year. This staggering sum is proof enough that healthcare fraud is here to stay as an unfortunate reality of the industry. Providers, patients, and insurers alike have all been complicit in various scams and schemes – which brings to mind the…

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Posted and filed under Community, Fraud.

Keep Your Holiday Season Fraud-Free

As the holiday season nears its zenith it can become extremely difficult to maintain your defenses against the myriad of fraud schemes that plague our capitalistic society. Luckily, Florida Attorney General Pam Bondi has your back! In her presentation, “2017 Holiday Consumer Protection Guide”, she outlines a number of safety precautions, product safety information, and…

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Posted and filed under Compliance, Fraud, FWA.

Advize Returns From NHCAA 2017

Last year we had the ONE AND ONLY cheapest.booth.ever featured at NHCAA’s Annual Training Conference. This year Advize brought guacamole and cookies to the table at the Even Cheaper Cheapest Booth Ever. Advize Health had the honor of speaking with some of NHCAA’s Annual Training Conference (ATC) attendees right in our backyard. The ATC is widely-regarded…

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Posted and filed under Community, Events, Healthcare.

Guide to NHCAA 2017 Meeting Spots in Orlando FL

This week, from November 14th to the 17th, Orlando’s Rosen Shingle Creek will be the epicenter of healthcare fraud’s biggest conference, NHCAA’s Annual Training Conference. ATC will undoubtedly unveil some incredible thought leadership and innovation – but is it the right place to build a last business relationship? Conferences have a proven track record of…

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