Posted and filed under Fraud, FWA, Healthcare, Medical Record Auditing.

3 Quick Tips to Avoid an Audit

Healthcare providers have a lot on their minds. Between daily rounds, patient care, and an ongoing global pandemic – it’s not easy to stay on top of administrative tasks like documentation and medical record maintenance. Even so, medical record review is a critical function of the healthcare ecosystem. The reality is that there are a lot…

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Posted and filed under Dental, Fraud, FWA, Medical Record Auditing.

A Frank Discussion on Dental Fraud

Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an additional $10 for personal protective equipment (PPE) on top of her dental visit. Other members…

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Posted and filed under Compliance, Fraud, FWA, Medical Record Auditing.

Fraud Spotlight: Provider Negligence & Ignorance are Non-Compliance

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  For the past few weeks, we have been standing on the soapbox and waving the flag…

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HCCA Web Conference – Medical Records Requested #ChallengeAccepted

Advize Health is proud to announce an upcoming web conference hosted by the Health Care Compliance Association. We’ve packaged up what we’ve learned through years of medical record retrieval projects, and created a a one-hour presentation with the tips, tools, and trick needed to pull off a high stakes retrieval project.

Posted and filed under Careers, Coding.

You’re Credentialed – So What?

The following blog post was written by one of Advize Health’s most experienced auditors; Dawn Landry. No matter what we do in life, only experience makes us better. None of us walked, rode a bike, or swam perfectly the first time we tried. We had to invest time and effort into first learning and then…

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Posted and filed under Fraud, Medical Record Auditing.

Behavioral Health Billing Errors

A 2017 audit fronted by Massachusetts State Senator Suzanne M. Bump revealed over $190 billion dollars in improper or ambiguous payments within MassHealth’s Behavioral Health program. The audit uncovered years of questionable billing practices, lack of administrative oversight, and conflicting understandings of requirements, regulations, and internal policies. The Senator went on the record explaining the…

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Posted and filed under Coding, Payers.

We Need to Talk About Transgender Healthcare

Earlier this week, Advize Health partnered with Grassi Healthcare Advisors to host a webinar on transgender healthcare. This webinar sought out to educate the healthcare community not only on coding for transgender patients, but on every aspect of care for this critically underserved population, from claims denials to the cost of transitioning. The convergence of…

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