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Episode 18: Trials & Tribulations of Trials & Tribulations with Sean “The Compliance Guy” Weiss

Episode 18: Trials & Tribulations of Trials & Tribulations with Sean “The Compliance Guy” Weiss

by Advize Admin | Jan 20, 2023

OIG Roundtable (Formerly Retro Fraud) Episode 18: Trials & Tribulations of Trials & Tribulations with Sean "The Compliance Guy" Weiss Play Episode Pause Episode Mute/Unmute Episode Rewind 10 Seconds 1x Fast Forward 30 seconds 00:00 / 52:16 Subscribe Share Spotify RSS...
MA and Risk-Scoring, We Can Do Better (and Advize does)

MA and Risk-Scoring, We Can Do Better (and Advize does)

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...
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

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...
Episode 18: Trials & Tribulations of Trials & Tribulations with Sean “The Compliance Guy” Weiss

Episode 9 – UPIC Challenges in Medicare and Medicaid investigations

by Advize Admin | Oct 28, 2022

OIG Roundtable (Formerly Retro Fraud) Episode 9 - UPIC Challenges in Medicare and Medicaid investigations Play Episode Pause Episode Mute/Unmute Episode Rewind 10 Seconds 1x Fast Forward 30 seconds 00:00 / 25:55 Subscribe Share Spotify RSS Feed Share Link Embed...
Centene Agrees to Pay Massachusetts $14 Million Over Medicaid Prescription Claims

Centene Agrees to Pay Massachusetts $14 Million Over Medicaid Prescription Claims

by Advize Admin | Sep 30, 2022 | Compliance, FWA

Massachusetts has become the latest state to settle with health insurance giant Centene Corp. over allegations that it overbilled the state’s Medicaid program for pharmacy services, KHN has learned. Centene, the nation’s largest Medicaid managed-care insurer, will pay...
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