by Advize Admin | Sep 8, 2016 | FWA
Last week, Advize Health returned to Florida after fighting fraud in Baltimore during NAMPI 2016. This annual National Association for Medicaid Program Integrity took place from August 28-31st, and was held at the Baltimore Marriott Waterfront Hotel. This conference...
by Advize Admin | Jan 22, 2016 | FWA
Stringent billing guidelines and regulations are often instituted to limit the incidence of fraud, waste, and abuse (FWA). Specificity increases annually, providing a well-developed outline for physicians and billers. Revisions to billing procedures are designed to...
by Advize Admin | Jan 20, 2016 | FWA
A major case of criminal activity has made its way to the courts, and is a prime example of the importance of auditing medical records. The work of auditors focusing on fraud, waste, and abuse may often be overlooked by many in the healthcare field – but in...
by Advize Admin | Dec 16, 2015 | Coding, Medical Record Auditing
There are many techniques to extracting data that can range from reviewing claim line billing data to actual medical record reviews. Relying exclusively on the claims data to analyze and identify atypical billing patterns or potential red flags is always challenging....
by Advize Admin | Oct 19, 2015 | Fraud, FWA
Whistleblower Lawsuit Leads to Record Setting Settlement for Adventist Health System Adventist Health System will pay $118.7 million to the federal government and four states to settle a whistleblower lawsuit filed in December 2012. The lawsuit alleged that Adventist...
by Advize Admin | Sep 28, 2015 | FWA
Affordable Care Act Fraud Criminals Facing Tougher Sentences Due to the Affordable Care Act, criminals convicted of fraud now face tougher sentences and more jail time. Criminals will receive 20 to 50 percent longer sentences for crimes that involve more than $1...
by Advize Admin | Aug 25, 2015 | FWA
DOJ and HHS Annual Report Highlights $3.3 Billion in Settlements and Judgments in FY 2014 “On March 19, 2015, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) issued their annual Health Care Fraud and Abuse Control (HCFAC) Program...
by Advize Admin | Apr 29, 2015 | FWA, Healthcare
Fraud accounts for 19% of the $600 to $800B in waste in the U.S. healthcare system annually, including everything from bogus Medicare claims to kickbacks for worthless treatments and other services. 57% of insurers expect to see an increase in fraud losses this year...
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