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 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...
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...
by Advize Admin | Aug 12, 2022 | OIG Files
If you missed Eric opining on LinkedIn this week, here are some quick pieces of information including: an infectious disease doctor, a case in NJ, and a Bill that was signed into law. Another great case from my former OIG coworkers in NJ. This one should concern...
by Advize Admin | Jul 1, 2022 | Compliance, Events, Healthcare, Technology
Recently we presented to New York State Adult Day Services Association (NYSADSA) on this very topic. For those of you who do not know, NYSADSA is comprised of individuals, single-site programs, multiple-site programs, professional organizations, and supporters...
by Advize Admin | Mar 18, 2022 | FWA
Last spring, Lags Medical Centers, a sprawling chain of pain clinics serving more than 20,000 patients in California, abruptly shuttered amid a cloaked state investigation into “credible allegations of fraud.” Tens of thousands of patients were left scrambling for...
by Advize Admin | Jan 11, 2022 | OIG Files
For those of you who have been keeping up with the Elizabeth Holmes/Theranos trial, you likely have seen that there was a very mixed verdict. Holmes was convicted on some counts, acquitted on some and the jury was deadlocked on others. From a reader’s perspective, it...
by Advize Admin | Sep 3, 2021 | Healthcare
In the rural northeastern corner of Missouri, Scotland County Hospital has been so low on staff that it sometimes had to turn away patients amid a surge in covid-19 cases. The national covid staffing crunch means CEO Dr. Randy Tobler has hired more travel nurses to...
by Advize Admin | 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 Advize Admin | Dec 9, 2020 | Fraud, FWA, Healthcare, Medical Record Auditing
Healthcare providers have a lot on their minds. Between daily rounds, patient care, and an ongoing global pandemic – it’s not easy to stay on top of administrative tasks like documentation and medical record maintenance. Even so, medical record review is a critical...
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