Maximize Recovery and
Go Beyond Fraud Detection.
We recognize the critical importance of SIU in healthcare operations. Our team brings a wealth of expertise and a proven track record in safeguarding financial resources, ensuring compliance, and driving efficiency across your SIU. We are committed to guiding you through the intricacies of investigations.
We specialize in differentiating between crucial and minor cases, exploring each lead with expertise, critical thinking and clarity.
Our Team:
– SIU Investigators
– Clinical Auditors
– Coding Auditors
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Are we as Investigators really looking at all aspects of opportunity to enhance recovery by doing a proper due diligence each time? An Investigator can use creative thinking to make the most out of each opportunity, regardless of whether your investigation is a lion or a lamb.
By Carey Mead – Lead Investigator Advize Health LLC
In situations where resources are limited, Advize steps in with:
– Experienced investigators and clinical staff to pinpoint potential fraud, waste, and abuse using our tailored solutions.
– Our team collaborates closely with Health Plan’s SIU or Compliance departments to proactively pursue improper payment recoveries, administrative actions, and support fraud referrals to law enforcement.
Backlog Burnout
The Challenge
One large payer needed close to 200 aged investigations to be worked. Another payer required over 400K reviews of appealed audits. Both requests required experts to identify FWA and document findings to recover improper payments.
The Solution
We utilized our flexible bench of incredible talent to quickly onboard a team of specialty and skill-specific experts to perform reviews and investigations. We expedited results and delivered backlog resolution within the specified timeframe.
The Outcome
We onboarded clinical and non-clinical reviewers along with investigators to provide expert work that not only resolved the backlog but also delivered greater ROI than the payers would have achieved if staffed internally.
Partner with us to optimize your investigations for success and unlock the full potential of your SIU’s capabilities.