Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Telehealth & Telemedicine

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. The topic of telemedicine and telehealth has been a very hot topic in…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Unconventional 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. In my blog posts the past few weeks, I discussed those instances when…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Developing a Kickback Case

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 continue to be amazed at the fact that healthcare providers are 1,…

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Posted and filed under Fraud, FWA, Healthcare.

Tips for Selecting a Subject Matter Expert

Litigation is a lengthy process and one that requires the involvement of a multitude of people throughout its life cycle. More often than not, an Expert Witness or Subject Matter Expert (SME) will need to be called in. This holds true across all areas of legal practice, and the hunt for a qualified, objective SME…

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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 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 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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Posted and filed under Fraud, Medical Record Auditing.

Behavioral Health Billing Errors

A 2017 audit fronted by Massachusetts State Senator Suzanne M. Bump revealed over $190 billion dollars in improper or ambiguous payments within MassHealth’s Behavioral Health program. The audit uncovered years of questionable billing practices, lack of administrative oversight, and conflicting understandings of requirements, regulations, and internal policies. The Senator went on the record explaining the…

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

Your Data Will Be Stolen

This article is a continuation of Risky Retrievals. Walk-Ins Welcome Our medical record specialists are required to arrive at each facility with their equipment, as well as their ID badges and driver’s licenses. This is to ensure that their identities can be verified by office staff and reporting in the event of an incident. What…

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