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 Fraud, FWA, Healthcare.

Fraud Spotlight: COVID-19 Fraud Schemes & Paradigm Shifts

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. With every single social media post out there is about Coronavirus (and just…

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Posted and filed under Fraud, FWA, Healthcare.

COVID-19’s Impact on Telemedicine & Reimbursements

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. Under Medicare rules, telemedicine, or telehealth as it is also commonly known, required…

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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 Community, Fraud, FWA, Healthcare.

Fraud Spotlight: Prevention Through Medicare Literacy

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. With the New Year will come an increase in Medicare premiums for those…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Human vs Machine

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 I attended a CMS “listening session” hosted by the Center…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Specific Deterrence

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. As some of you may have seen in a LinkedIn post I wrote,…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The Mission of CMS & The OIG

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, the CMS Administrator made some comments that outlined some new initiatives…

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AAPC Local Chapter Meeting: Home Visit & Podiatry Fraud Schemes

Join Advize Health’s Director of Litigation, FWA Support in an interactive session on home visit and podiatry fraud schemes. This session, available to AAPC members local to the Manhattan NY chapter will have the opportunity to earn 2 AAPC approved CEUs with content delivered by a retired OIG Special Agent. The session will: Review the…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Medicare Beneficiaries

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. Several weeks ago, I wrote a blog post about a case that I…

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