Posted and filed under Commentary.

The Price We Pay

Does anyone really know how our healthcare system works? There is so much discussion on the issues about our healthcare system and how it can be fixed that it is overwhelming. Generally, articles and books are written in a language or style that makes it difficult to understand with assumptions and inside information and terminology…

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Posted and filed under COVID19.
covid19 cigarette smoking

COVID19: Smoke for a Cure

I’ve always had a dream that when I turned 50 I would move to Paris and take up smoking. But lately I have been thinking, why wait? I want the COVID19 vaccine ASAP, but I can’t get it. It turns out smokers are eligible for the vaccine without even needing proof. New Jersey is one…

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Posted and filed under Fraud, Healthcare.
Posted and filed under Coding, Dental, Fraud, FWA.

Dental Fraud: Isolated or a Pattern?

This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out some basics of dental misconduct – fraud.  A dentist who bills for services not performed is committing fraud.  For example, billing for the…

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

Fraud Spotlight: How Crises Can Impact Fraud Investigations

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. Hurricane Katrina and COVID-19, what do these two very different things have in…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Provider Credentials, Fraud, & COVID-19

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 From a resource perspective, we as a nation, and those in the law…

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

Fraud Spotlight: Advance Directives Prevent Healthcare Fraud

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. I’m going to preface this by saying what I’m about to write about…

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Posted and filed under Community, Healthcare, Technology.

Healthcare Heroes: Industry Disrupters

A pandemic is wreaking havoc across the globe. The healthcare system is layered in bureaucracy that stagnates progress and stonewalls idealism. Sometimes, it seems like the fight is futile…but it’s not. What healthcare needs is a disrupter (or disruptor, depending on your preference), and lucky for us, there are already several making waves in the…

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

Fraud Spotlight: You Can’t Cut Corners in Compliance

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. We have all heard the phrase “a penny wise, but a pound foolish,”…

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

Fraud Spotlight: The Use & Abuse of Modifier 25

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.  Modifier 25.  It has been the bane of existence for fraud, waste and…

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