Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Kickbacks

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. People inherently trust their healthcare provider.  You go to your practitioner and expect…

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Posted and filed under Healthcare, Payers.

HEDIS Season: The Home Stretch

As we approach the month of June, we also begin our downward slide towards the end of HEDIS season. HEDIS season, in all its glory, stretches through about 3 calendar seasons – and requires hard work from providers, chart reviewers, and record collection companies from December through October – depending on program enrollment, measures, and…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

What Do You Hate Most About Healthcare?

Last night, Advize Health had the opportunity to present before one of the largest chapters of its kind in the United States. The audience, comprised largely of credentialed medical coders and billers who assemble to discuss their professional and issues within the industry, were given the opportunity to explore healthcare fraud from two different perspective….

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Posted and filed under Healthcare.

This Month in Healthcare

Healthcare is constantly in a state of transition, and it doesn’t take the summers off. July has seen several CMS announcements, innovations, and healthcare fraud busts. Hot off the digital presses, Advize has rounded up this month’s biggest stories so far. 2018-07-19 – IHS Launches Opioids Website The Indian Health Services launched their new opioid…

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Posted and filed under Healthcare.

Should All Office Visits Be Created Equal?

Physicians have had no reservations making their aversion to paperwork known, as evidenced by countless essays criticizing documentation requirements and the time management hurdles imposed by these steep expectations. Many discounted the protests of physicians, attributing their disdain to laziness; or something even more sinister: a scapegoat for non-compliance, errors, and even fraud. As the…

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Posted and filed under Compliance, Payers.

Meet Your New MBI

If you’re covered by Medicare, or if your patients are covered by it – you’re about to start feeling more of the effects of The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Most organizations have been preparing for MACRA’s ripple effects for years, so this wave of change may just be another to…

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Posted and filed under Cybersecurity, Events, Technology.

Sound Bites From HIMSS18

HIMSS 2018 returned to the bustling city of Las Vegas for the first time since 2016 determined to keep their promise of being “where the world connects for health”.  Drawing in guests from around the world, HIMSS is the premiere conference for those working in the healthcare technology space. With a focus on innovation, interoperability,…

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Posted and filed under Compliance, Technology.

EHR Incentive Program Deadlines

The Medicare and Medicaid EHR Incentive Programs were designed to provide eligible professionals (EPs) the opportunity to receive EHR incentive payments as they adopt, implement, upgrade, or practice meaningful use of relevant EHR technologies. The EHR Incentive Programs have three stages: Stage 1 set the foundation for the EHR Incentive Programs by establishing requirements for…

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Posted and filed under Community, Healthcare.

CMS Offers Aid to Hurricane Maria Victims

Seema Verma, administrator of The Centers for Medicare & Medicaid Services announced earlier this week that the organization would be stepping up to help Puerto Rico and the U.S. Virgin Islands after Hurricane Maria’s reign of destruction. Health and Human Services has already declared public health emergencies in these affected territories, eliciting help from a…

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Posted and filed under Coding, FWA.

Investigating Health Plan Overpayments

Picture yourself balancing on top of a fence with vast expanses of land, each with their own set of governance, visible to you from both sides. You’re straddling the fence, your legs occupying each of the divided spaces. Where do you stand? It depends on which way the wind blows. Such is the case with…

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