by Advize Admin | May 26, 2023 | Coding, FWA
Within the past few weeks, we have seen at least two of the large payors seek to institute policies that would require providers to submit their medical records when an Evaluation and Management (E&M) is appended with Modifier 25. While not having a discussion on...
by Advize Admin | Dec 2, 2022 | Compliance, FWA, Medical Record Auditing, OIG Files
When you first open this article, the most glaring of things is the time frame from which the audit was derived. 2011-2013 data is at this point so aged, the calculation of $1,000 per patient enrolled in a Medicare Advantage (MA) as the overcharged amount is simply...
by Advize Admin | Dec 2, 2022 | Coding, FWA, Medical Record Auditing
Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which...
by Erik Consorsha | Aug 27, 2021 | Medical Record Auditing
A little background, one of areas where Advize provides consulting services is in the medical record review space. We have been providing this service to clients for over 20 years, both proactively, and reactively. Our CEO, Jeanmarie Loria, was actually a...
by Erik Consorsha | Sep 18, 2020 | Coding, Dental, Fraud, FWA
This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column next week for more examples of dental fraud from real cases! This article points out some basics of dental misconduct – fraud. A dentist who...
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