Fraud Hunters: Claim Determinations

Fraud Hunters: Claim Determinations

Self doubt is a necessary part of the process when making claim determinations. As a reviewer, you have the ultimate decision-making authority as to whether a re-opened claim should be denied and the money recouped.  You should be asking yourself whether the...
Meet Jessica.

Meet Jessica.

We managed to interrogate our newest SIU Investigator, Jessica Rodriguez, with some top tier healthcare reporting news anchor-like questions. This is how she stacked up under the pressure. What were you doing before you joined Advize? I was an Investigative Auditor...
Meet Rachel.

Meet Rachel.

We managed to stop Advize’s new President for a few so that we could do a little hard hitting journalism and find out not only what makes her tick but how tall her childhood garden gnome was. What were you doing before you joined Advize? For the last 15+ years...
Moral Injuries

Moral Injuries

If you are an avid reader of our newsletter or blogs, you know that we focus on payment integrity, program integrity, fraud waste and abuse, and the cost/quality of healthcare. We are often talking about the business behind healthcare, and not necessarily the doctors...
Be Proud: The Untold Story of an Auditor

Be Proud: The Untold Story of an Auditor

Who is David Bolden? Born in Silver Spring, MD on June 8, 1983, David was cast into a world that he would quickly realize was both full of adventure and heartache. I am not sure why writing in third person feels like the beginning of an action movie, but let’s go with...

In Case You Missed It: Fraud is Afoot Webinar

Dr. Cicio has been in the podiatry and FW industry for over 40 years and has a wealth of experience and insight in the field of podiatry, the fraud schemes and some tricks, tips and tools that can be utilized to ferret out FWA in your payment integrity programs. Eric...
Healthcare: Tipping Culture

Healthcare: Tipping Culture

Are you tired of tipping the “obligatory” 20%?  I believe everyone (companies and people) should get paid what they deserve.  I often tip 50% but sometimes I tip $1.  It is performance based. Continuing on with international and summer...