Posted and filed under Compliance, FWA, Medical Record Auditing, Payers.

Fraud Spotlight: Document Now, Ace an Audit Later

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. Every day, we read another article or another news release about the ever-changing…

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

Fraud Spotlight: Understanding the 3 Types of BLS Transport

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. Previously, I wrote a couple of blogs about the continued fraud in the…

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

The 3 Ws of USDHHS OIG OI

Peggy Glynn, a former OIG Field Agent returns in this week’s guest blog post. Her friendship, insights, and experiences in the OIG are incredible tools for those looking to learn more about fighting healthcare fraud, waste, and abuse. What is the USDHHS? Who is the OIG? Why do you care about the OI? What: USDHHS…

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

Fraud Spotlight: Types of Healthcare Fraud Cases

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 Last week, I discussed the three main types of subpoenas that are typically…

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

Fraud Spotlight: The Kyphoplasty & The Qui Tam

This week’s Fraud Spotlight article was written by Peggy Glynn, a former OIG Field Agent from Buffalo, NY. Her friendship, insights, and experiences in the OIG are incredible tools for those looking to learn more about fighting healthcare fraud, waste, and abuse. Who is Kyphon Inc., what is a kyphoplasty, and where does the Civil…

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

Fraud Spotlight: Economic Healthcare Fraud Perspectives

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.  This past week, while having lunch with a friend who knew about my…

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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, Community, Medical Record Auditing.

Where To Find Free CEUs

Continuing Education Units (CEU) for healthcare professionals who are credentialed by the AAPC are worth their weight in gold. CEUs are a necessary tool for all medical coders and auditors as they are not only required for certification maintenance, but because they keep professionals current on industry trends. The AAPC has a set of guidelines…

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Posted and filed under Events, FWA, Medical Record Auditing.

ICYMI: 2018 OIG Work Plan Webinar

Advize Health’s first webinar of the new year will be broadcasting live today from 2:00PM EST until 3:30pm EST. The program will break down the 2018 OIG Work Plan and provide an in-depth examination at the OIG (Office of Inspector General) and their efforts in the fight against fraud. From mandatory requirements, to laws and…

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

Risky Retrievals

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…

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