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…
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…
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…
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:…
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…
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…
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…
If you read the news, you know that health care fraud is just as prevalent as ever. During any given time, you will be able to find a headline about a provider or care giver defrauding patients, insurance companies, or CMS in every state across the nation. This month we’ve seen quite a few colorful…
Advize Health kicked off the month of April by diving headfirst into Conference Season, and attending the Eastern Claims Conference in Boston, MA. The Eastern Claims Conference, recently relocated from New York to Massachusetts was an impressive assembly of insurance professionals. Catering to life, disability, medical, legal, and insurance claims; the Eastern Claims Conference has…
If healthcare was a chemical solution, and relevant technologies were solutes – the mixture would quickly become a fragmented clump of, well…various technologies. The healthcare market is over-saturated with technology designed to “fix” the present problems plaguing the ecosystem. Of course, in a paradoxical twist of fate, these solutions come with a new set of…