Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: Detecting & Investigating FWA during COVID-19

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. We hopefully are seeing the beginning of the end with COVID-19, but we will certainly not see…

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Posted and filed under Community, Fraud, FWA, Healthcare.

Fraud Spotlight: Year in Review

The year 2020 was ripe with unprecedented challenges. Between a global pandemic, civil unrest, and rampant socio-political uncertainty…there was a lot to deal with. The healthcare industry was thrust into the spotlight, first for its heroes on the frontlines, then for its billing practices. COVID-19 put medical documentation under a microscope, examining everything from cause…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

Legal Violations Against Physical Therapists: Part II

It’s more than money when your license is on the line.  This week’s Fraud Spotlight features guest contributor Mark R. Brengelman, JD, MA. Be sure to tune into the column for more expert insights from our network of providers, investigators, and fraud experts. This article continues a multi-part series that will be covering the top ten violations…

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Posted and filed under Fraud, FWA, Healthcare, Medical Record Auditing.

3 Quick Tips to Avoid an Audit

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 function of the healthcare ecosystem. The reality is that there are a lot…

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Posted and filed under Fraud, FWA, Healthcare.

Fraud Spotlight: The OIG, Speaker Programs & Kickbacks

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. A couple of weeks ago, the OIG issued a Special Fraud Alert regarding the use of speaker…

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Posted and filed under Coding, Fraud, FWA.

Fraud Spotlight: Providers & The “Impossible Day”

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes. When a provider commits healthcare fraud, and they hit all the “goodies,” we just have to…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.
Posted and filed under Compliance, Dental, Fraud, FWA.

Dental Fraud from a Different Perspective

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 a unique aspect about dental fraud that has significant impacts on the dental office and the dentist who practices there –…

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Posted and filed under Dental, Fraud, FWA, Medical Record Auditing.

A Frank Discussion on Dental Fraud

Our Founder and Managing Director Jeanmarie Loria sat down with retired OIG Special Agent Eric Rubenstein to discuss dental fraud, unscrupulous dentists, and the claims-related intricacies of the dental industry. Here’s how it went… JL: My aunt in California paid an additional $10 for personal protective equipment (PPE) on top of her dental visit. Other members…

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Posted and filed under Compliance, Fraud, FWA, Medical Record Auditing.

Fraud Spotlight: Provider Negligence & Ignorance are Non-Compliance

The Fraud Spotlight series is a long-form examination of current fraud trends and investigative strategies from our team of retired OIG agents and expert fraud investigators. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive crimes.  For the past few weeks, we have been standing on the soapbox and waving the flag…

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