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

Dental Fraud: Standard of Care Violations

Even more than money … what about the standard of care? This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article points out another violation of law related to dental misconduct in addition…

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Posted and filed under Dental, Fraud, FWA.

Dental Fraud: More Than Money

This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. …What do the records say? This article points out additional violations of law related to fraudulent dental misconduct – medical records forgery or simple lack…

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Posted and filed under Dental, Fraud, FWA.

Fraud Spotlight: Why Dental Fraud is Overlooked & Ignored

Over the past few weeks, we have been blogging and posting about the “red-headed step-child” of healthcare fraud, dental fraud. One of our retired OIG agents recently heard this tale, which bears repeating: At a recent visit, his mother was told by the treating dentist that she had a gum infection and needed to see…

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Posted and filed under Coding, Dental, Fraud, FWA.

Dental Fraud: Isolated or a Pattern?

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 some basics of dental misconduct – fraud.  A dentist who bills for services not performed is committing fraud.  For example, billing for the…

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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 Dental, Fraud, FWA, Medical Record Auditing.

A Frank Discussion on Dental Fraud

Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an additional $10 for personal protective equipment (PPE) on top of her dental visit. Other members…

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Posted and filed under Dental, Fraud, FWA, Uncategorized.

Rinse & Spit: Investigating Dental Fraud

Next Week On The Blog: Jeanmarie Loria sits down with her partner Eric Rubenstein, retired OIG Agent, to ask him why he had more cases on pharmacy pain management and DME than dental fraud.  Dental fraud stinks worse than the most severe case of halitosis.    Picture this.   Brooklyn NY 1960. All 5 of…

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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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