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

Dental Fraud from a Different Perspective

This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out a unique aspect about dental fraud that has significant impacts on the dental office and the dentist who practices there –…

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

MSP 101: A Brief Overview

Friend of Advize and healthcare payer expert Dino Kasdagly put together a helpful resource for healthcare professionals looking to quickly refresh their knowledge on Medicare as a Secondary Payer practices. Below you will find several popular instances in which Medicare benefits are secondary to Group Health Plan (GHP) benefits.  If the documented employer has more…

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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…

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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…

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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…

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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…

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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…

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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…

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Posted and filed under Compliance, Fraud, FWA.

Profiting Off Of COVID-19? You Better Be Documenting.

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 couple of weeks, I have seen an unbelievable number of…

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