by Advize Admin | May 26, 2016 | Dental, FWA
As an auditing firm, we are well aware that dental fraud is alive and well in the American healthcare system. With so many American children covered by Medicaid, dentists have taken it upon themselves to begin offering unnecessary and Al-La-Carte services in order to...
by Advize Admin | May 3, 2016 | Compliance, FWA
A tidal wave of fraud has been approaching our shores for quite some time, and it’s finally broken land. The scheme, gaining popularity in clinical labs and pathology groups involves waiving patient fees and copays in order to send payer groups inflated claims fees....
by Advize Admin | Apr 26, 2016 | Coding, FWA, Payers
Billing issues, to an extent, are expected in any physician or healthcare provider office. Most patients are in possession of both medical and vision benefits coverage, and this duality often causes confusion in ophthalmology offices. Certain procedures that are...
by Advize Admin | Jan 25, 2016 | FWA
Many members of the Advize Health staff call Winter Park, Florida their home. Winter Park is a historic city populated by private colleges such as Rollins College, boutique hotels with enviable veranda views, picturesque canopies of Spanish moss, and a small number...
by Advize Admin | Jan 22, 2016 | FWA
Stringent billing guidelines and regulations are often instituted to limit the incidence of fraud, waste, and abuse (FWA). Specificity increases annually, providing a well-developed outline for physicians and billers. Revisions to billing procedures are designed to...
by Advize Admin | Jan 20, 2016 | FWA
A major case of criminal activity has made its way to the courts, and is a prime example of the importance of auditing medical records. The work of auditors focusing on fraud, waste, and abuse may often be overlooked by many in the healthcare field – but in...
by Advize Admin | Jan 13, 2016 | FWA
Recently, the U.S. Government has been undertaking regulatory activities to drive down healthcare costs and improve patient outcomes. It is crucial to keep an eye on published regulations. One of the Centers for Medicare and Medicaid Services’ (CMS) key goals is to...
by Advize Admin | Oct 19, 2015 | Fraud, FWA
Whistleblower Lawsuit Leads to Record Setting Settlement for Adventist Health System Adventist Health System will pay $118.7 million to the federal government and four states to settle a whistleblower lawsuit filed in December 2012. The lawsuit alleged that Adventist...
by Advize Admin | Sep 28, 2015 | FWA
Affordable Care Act Fraud Criminals Facing Tougher Sentences Due to the Affordable Care Act, criminals convicted of fraud now face tougher sentences and more jail time. Criminals will receive 20 to 50 percent longer sentences for crimes that involve more than $1...
by Advize Admin | Aug 25, 2015 | FWA
DOJ and HHS Annual Report Highlights $3.3 Billion in Settlements and Judgments in FY 2014 “On March 19, 2015, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) issued their annual Health Care Fraud and Abuse Control (HCFAC) Program...
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