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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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 Community, FWA, Healthcare.

Program Integrity Perspectives

The LA Times recently featured a story on a New England labor union that kept medical bills in check. “Everyone says we can’t do anything about costs, or we just have to get patients to put more ‘skin in the game,’” said John Brouder, a longtime health benefits consultant who worked with [the union] Local 26 to develop…

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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 Community, FWA, Healthcare.

New Year. New Decade. Same Old Healthcare Story.

A message from our Managing Director, Jeanmarie Loria. Good afternoon friends, and Happy New Year. I wish you and your loved ones all the best this year and decade. When I was a kid, my New Year’s tradition was to watch the Twilight Zone with my family. Now, that tradition has evolved into me watching…

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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 Community, Healthcare.

5 Ways to Have a Better Day

As a part of our YogAuditing initiative, Advize Health has brought on board two yoga instructors dedicated to the practice and its principles. Designed to enrich life and improve work performance, YogAuditing is a movement to inspire movement. Follow the journey with us by subscribing to our newsletter, reading our blogs, tuning in to our…

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Posted and filed under Fraud, FWA, Healthcare.

Tips for Selecting a Subject Matter Expert

Litigation is a lengthy process and one that requires the involvement of a multitude of people throughout its life cycle. More often than not, an Expert Witness or Subject Matter Expert (SME) will need to be called in. This holds true across all areas of legal practice, and the hunt for a qualified, objective SME…

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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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