by Advize Admin | Feb 17, 2023 | OIG Files
“After 11 months of largely sitting alone in his room undergoing what the hospital called “Chair Therapy” (sit and think about your life) he left that hospital a broken teenager.” Return on investment is a calculation that Special...
by Advize Admin | Jan 27, 2023
OIG Roundtable (Formerly Retro Fraud) Episode 19: How CMS FWA Directives Can Help Operationalize an SIU Play Episode Pause Episode Mute/Unmute Episode Rewind 10 Seconds 1x Fast Forward 30 seconds 00:00 / 38:35 Subscribe Share Spotify RSS Feed Share Link Embed Download...
by Advize Admin | Jan 20, 2023 | OIG Files
We work very closely in the payor and provider space to ensure that fraud, waste, abuse (FWA) and compliance are at the forefront of the payment integrity continuum. This is particularly the case when working to conduct medical record reviews and identify over...
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...
by Advize Admin | Jan 13, 2023
OIG Roundtable (Formerly Retro Fraud) Episode 17: Fraud Predictions for 2023 Play Episode Pause Episode Mute/Unmute Episode Rewind 10 Seconds 1x Fast Forward 30 seconds 00:00 / 33:08 Subscribe Share Spotify RSS Feed Share Link Embed Download file | Play in new window...
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 | Oct 21, 2022 | Advize News, Compliance, Events
This week two of Advize Health’s own former HHS-OIG experts, Matt Kochanski and Wade McFaul presented a conversational webinar on Organized Fraud. Matt and Wade discussed their experiences with the types of fraud and various ways they investigated these cases. ...
by Advize Admin | Sep 8, 2022 | FWA, OIG Files
Open enrollment will be upon us in the coming month. With it will come a slew of fraud complaints as it relates to managed care enrollment. Brokers work to enroll eligible members into plans that are supposed to be the best suited for the member. ...
by Advize Admin | Sep 2, 2022 | Advize News, Commentary
My Thursday started in Philly then Maryland, DC, Atlanta for a quick layover and then ended in Orlando. What a day! The highlight of that 5 city day was going back to Maryland again this week but only this time, the area was Fort Washington and some of the...
by Advize Admin | Aug 26, 2022 | Commentary, OIG Files
A phrase that does not often come up is “medical loss ratio,” or MLR. As an OIG Agent, I spent very little time looking at the OIG Workplan (I’ve blogged and spoken about how OIG Agents follow the current frauds, and how the plan is very much used to direct the work...
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