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 Coding, Fraud, FWA, Healthcare.

Fraud Spotlight: Providers & Deferred Prosecution Agreements

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. Over the past few weeks, I have been discussing the investigative process.  From…

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

Fraud Spotlight: Subpoenas, Complaints, & Indictments

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. Over the past several weeks, I discussed the different types of investigations that…

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

The 3 Ws of USDHHS OIG OI

Peggy Glynn, a former OIG Field Agent returns in this week’s guest blog post. Her friendship, insights, and experiences in the OIG are incredible tools for those looking to learn more about fighting healthcare fraud, waste, and abuse. What is the USDHHS? Who is the OIG? Why do you care about the OI? What: USDHHS…

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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 Uncategorized.

Fraud Spotlight: The 3 Subpoenas of 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 You are a provider, and one day while seeing patients, agents from the…

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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 Coding, Fraud, FWA, Healthcare, Medical Record Auditing.

Fraud Spotlight: Economic Healthcare Fraud Perspectives

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, while having lunch with a friend who knew about my…

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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: The Curious Case of EOB/EOMB

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. Explanation of Benefits (EOB). Explanation of Medicare Benefits (EOMB). For those of you…

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