There is absolutely nothing in this report that should be interesting, shocking, or otherwise reflective of surprise. $784 million in improper...
Medical Record Auditing Articles
Fraud Hunters: One Hit “Wonders”
Newly approved procedure codes, devices and DME are like the watering holes on the Serengeti. They are gathering spots for fraudsters and great...
Did Your Health Plan Rip Off Medicare?
Today, KHN has released details of 90 previously secret government audits that reveal millions of dollars in overpayments to Medicare Advantage...
MA and Risk-Scoring, We Can Do Better (and Advize does)
When you first open this article, the most glaring of things is the time frame from which the audit was derived. 2011-2013 data is at this point...
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges
Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some...
Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging
Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the...
Auditing Medical Records for Medical Necessity
A little background, one of areas where Advize provides consulting services is in the medical record review space. We have been providing...
10 Ways to Avoid an Audit
As new technologies progress more and more payers are actively deploying AI capable systems. This shift is now producing more...
3 Quick Tips to Avoid an Audit
Healthcare providers have a lot on their minds. Between daily rounds, patient care, and an ongoing global pandemic – it’s not easy to stay on top...
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,...
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...
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...
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