by Advize Admin | Apr 28, 2017 | Dental, Fraud, FWA
If you read the news, you know that health care fraud is just as prevalent as ever. During any given time, you will be able to find a headline about a provider or care giver defrauding patients, insurance companies, or CMS in every state across the nation. This month...
by Advize Admin | Nov 29, 2016 | Medical Record Auditing, Payers
The American Hospital Association recently released the results of a survey conducted to explore the efficacy of the RAC program in hospitals nationwide. The survey utilized the results responses submitted by 676 participating hospitals in order to explore the...
by Advize Admin | Jul 21, 2016 | Coding, FWA, Medical Record Auditing
A medical record audit can reveal over-payments for up-coding, incorrect numbers of units billed, and the abuse of modifiers – just to list a few. Given the popularity of such indiscretions, what is being done after the money is recovered? Do you intend on data mining...
by Advize Admin | Jan 13, 2016 | FWA
Recently, the U.S. Government has been undertaking regulatory activities to drive down healthcare costs and improve patient outcomes. It is crucial to keep an eye on published regulations. One of the Centers for Medicare and Medicaid Services’ (CMS) key goals is to...
by Advize Admin | Dec 18, 2015 | Healthcare
CMS released CY 2016 Outpatient Prospective Payment System (OPPS) Proposed Rule (CMS 1633 P). In which they propose to allow an exception to the controversial Two Midnight Rule. This proposed change is in recognition that there may be times when an inpatient admission...
by Advize Admin | Aug 25, 2015 | Coding, Compliance
Taking the Guesswork out of Correct Billing More and more health organizations are hiring midlevel providers to perform services that were formerly thought to be appropriate exclusively for medical physicians. While it is less costly to hire Physician Assistants,...
Recent Comments