government medical record review

Improper payments by Medicare and Medicaid programs were estimated at $64.8 billion for fiscal year 2011.
-Ref. The U.S. Government Accountability Office

Healthcare spending that’s attributable to waste, fraud, and abuse costs our system billions of dollars annually. Advize Health has developed an education program designed specifically for healthcare practitioners that teaches proper billing and guidelines which meets Medicare recommendations. Our programs train physicians and other practitioners on the criteria for all types and levels of consultations, with emphasis on the highest billing levels and follow-up inpatient consultations.

As a woman-owned small business, Advize Health has been able to make a large impact on the Federal and State government agencies. We have worked with large prime contractors to find and report fraud, waste and abuse.

An example of recent projects:

  • Medicaid Recovery Audit Contractor
    • Worked in the capacity of a subcontractor. Used appropriate CMS Audit Protocols along with the prime contractor to identify overpayments to Medicaid providers by reviewing medical and other supporting documentation for paid Medicaid claims.
  • Medicare Administrative Contractor
    • Worked in the capacity of a subcontractor. Reviewed DME cases using the prime contractors Local Coverage Determination policies and statutory requirements for Medicare.
    • Provided prime contractor with education based on the reviews

Contact us today for more information about how we can help you with our cost containment solutions.