?????? #FebruaryWebinar Hospice Fraud Alert: Combating Wrongful Billing Under Revenue Code 0650 Hospice fraud is more than just financial misconduct—it diverts critical resources from patients who need them most. With the growing misuse of Revenue Code 0650, it’s time to strengthen our defenses. Join us on Tuesday, February 25th at 1 PM ET for an exclusive webinar featuring experts from Advize and LA Care’s Special Investigations Unit (SIU). We’ll dive deep into real-world fraud schemes, share investigative strategies, and reveal how collaborative, data-driven efforts have led to significant recoveries. ?? Key Questions We’ll Address: - What are the latest trends in hospice fraud schemes? - How do fraudulent providers exploit Revenue Code 0650? - What investigative techniques uncover hidden fraud patterns? - How do UPICs and health plans collaborate to combat hospice fraud? - What proactive measures can organizations implement to prevent fraud? #HospiceFraud #RevenueCode0650 #FraudPrevention #HealthcareFraud #ProgramIntegrity #SIU #AdvizeHealth
Advize
医院和医疗保健
Orlando，Florida 55,313 位关注者
Healthcare & IT Audit & Advisory, Program Integrity, Compliance and Consulting for Payers, Providers, Legal & Government
关于我们
After nearly two decades of auditing large data sets and performing extrapolation for increased ROI for payers, Advize has shifted focus to building relationships with providers based on data and best practices. Our team has expanded our model of coding and billing audits focused on waste and abuse to examine fraud through Big-4 Data Analytics and OIG best practices. Audit and Support Services – Record Retrieval, Storage, Purge – Onsite record retrieval – Send request letters and other communications with providers – Secure file upload (SFU) – Records are stored securely and discarded in accordance with HIPAA recommendations and requirements – Minimum necessary PHI accessed – Record files are securely returned with audit result delivery – Corporate Integrity Agreements – Statistically valid sampling – Medical necessity and proper coding/documentation review – Audit Management and Quality Assurance Support – QA Review – Reporting and Results Delivery – Overpayment Recovery and Overpayment Support – Legal Support – Case building, expert witness, audit, reporting and testimony Review and Reporting – Reviews performed by highly experienced and credentialed auditors – Audit personnel work with a variety of healthcare personnel and patients. They should always conduct themselves in an acceptable, professional manner and adhere to ethical standards, confidentiality requirements, and objectivity. Auditors trained to completely document their findings and problems. – Perform verification of charges – What citations are important, and what policies are important? – Citation guidebook creation – Review of claims – Generation of preliminary audit results – Results delivery and collaboration with client – Report generation – Final Audit Results: – Contain final audit reporting, this reporting will have included the overpayment amount. – Review the next steps for the provider who was audited.
- 网站
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https://advizehealth.com
Advize的外部链接
- 所属行业
- 医院和医疗保健
- 规模
- 51-200 人
- 总部
- Orlando，Florida
- 类型
- 私人持股
- 创立
- 2003
- 领域
- Litigation Support、Medical Necessity、Record Collection、Claims Review、Healthcare、Claims、Healthcare Legal Support、Medical Records、Consulting、Expert Witness、HITRUST、FWA、OIG、CMS、UPIC、DRG、HCPCS、Arbitration、Audit、Advisory、Medical Record Audit、SIU、Compliance、Analytics、Federal、Healthcare Consulting、Expert Testimony、Hubzone、Women Owned、Government和CPC
地点
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主要
获取路线
US，Florida，Orlando
Advize员工
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Adam Labenow
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Jeanmarie Loria, MBA, PMP, CPC
CEO, Advize Health
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Brian Boyce
CEO, MHA, Risk Adjustment, RADV, HRADV, Clinical Bioethics, Healthcare Operations Consultant & Auditor, Aeromedical USAF Vet, Entrepreneur, Educator,…
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Jaysen Eisengrein, MBA, PgC, SAC (RET)
Retired HHS OIG Special Agent in Charge/Advize Health Special Director in Charge/FWA Consultant
动态
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We're #hiring a new Data Manager in United States. Apply today or share this post with your network.
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??Is your SIU facing case backlogs, resource gaps, or challenges with fraud, waste, and abuse prevention??? You're not alone—and we’re here to help! At Advize, we specialize in providing expert solutions to streamline your operations and enhance your team’s effectiveness. Whether it's expert staff augmentation, customized training, or tackling compliance challenges, we’ve got the tools to make a real difference. Take a look at our step-by-step guide to see how we can support your unique needs. Ready to take your SIU to the next level? Reach out and email us today—let’s discuss how we can work together to strengthen your operations and reduce risk. ?? #HealthcareIntegrity #SIUExcellence #FraudPrevention #ProgramIntegrity #WeAreHereToHelp | Carey Mead | Jeanmarie Loria, MBA, PMP, CPC | Eric Rubenstein, MSCJ, CFE | Dan Leslie | Mandi Berg | Matt Kochanski
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Still celebrating 10 years of Advize! ???? ?? Our very own Jaysen Eisengrein, MBA, PgC, SAC (RET) rocking the anniversary tee, representing a decade of integrity, impact, and partnership. Here’s to the next 10! #Advize10 #DecadeOfImpact #IntegrityInAction
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?? If your mind were an audit report, what would it reveal? We spend our days auditing claims, investigating fraud, and ensuring compliance, but how often do we audit our own mental space? - Are you running on accurate data or just reacting to false narratives? - Are you filtering out wasteful thoughts, or are you stuck in an inefficient loop? - Are you trusting verified sources, or are you believing every sensational headline? Just like in fraud investigations, misinformation in our own minds can distort reality. Before you accept a thought as truth, ask: Is this real, or is it just noise? This is Part 1 of our new series on mental clarity, decision-making, and resilience. Because protecting integrity starts from within. What’s one false claim about yourself that you need to debunk? #MentalAudit #MindsetMatters #ThinkBeforeYouTrust #AdvizeHealth
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We're #hiring a new Investigative Intern in United States. Apply today or share this post with your network.
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Breaking News: The Internet Lied to Us (Again) Ever see a headline so ridiculous you have to double-check if it’s satire? Well, here’s one: Social Security is sending checks to millions of dead people! Sounds scandalous, right? Too bad it’s complete nonsense. But here’s the real problem—it’s not just false, it’s dangerous. Misinformation like this isn’t just about getting clicks; it chips away at the trust we have in systems that actually work. And once that trust is gone? Well… good luck. So, before you hit share on the next “outrageous” claim, let’s take a step back. Are we thinking critically—or just fueling the chaos?
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?? Are We Wasting Time on Fraud, Waste & Abuse Labels? ?? Does it really matter if a case is classified as fraud, waste, or abuse—or are we just getting caught up in semantics? ?? In Episode 116 of OIG Roundtable, Eric Rubenstein, MSCJ, CFE, Wade McFaul, and Matt Kochanski tackle the long-standing debate on FWA terminology and why SIU teams should stay focused on the bigger picture: investigating cases and driving real impact. Are these labels helping or hindering the fight against fraud? Tune in to find out! ???? ?? Listen Now: https://lnkd.in/g7ZZNJff #OIGRoundtable #FWA #HealthcareFraud #SIU #FraudWasteAbuse #Investigations #Compliance
OIG Roundtable 116: Should We Care About If Something is F, W or A
https://www.youtube.com/
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We believe that growth and learning go hand in hand! ???? A huge thank you to Yarnell McGee RN, BSN, CPCM, CPC and Erick Kalobwe for such a valuable and insightful presentation during another great monthly All-Hands call. Your expertise helps us continue evolving as a team. Already looking forward to the next one! Dan Leslie??? #TeamAdvize #LifelongLearning #GrowthMindset"
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At an event, one writer marveled at the staggering wealth of a guest, calculating that the man made more in an hour than the writer would earn selling thousands of books. He turned to his friend, another writer, and asked: "How do you even compare to that?" The response? "I have something he doesn’t." Curious, the first writer leaned in, waiting for some grand revelation. "I have enough." This story, shared in a conversation with our coach Emily Griffith, struck a chord. At Advize, we believe in this kind of wealth—the kind that comes from valuing what we already have. A team built on integrity. A mission with purpose. A commitment to real impact. While others chase more, we focus on better—nourishing our people, refining our craft, and strengthening our partnerships. Because when you have enough of the right things, you already have everything you need to change the game. - What does “having enough” mean to you in your work and life? - Where do you see the difference between chasing more and focusing on better? - How do you nurture what you already have to create lasting impact? #Integrity #HealthcareExcellence #AdvizeHealth #StrengthInEnough
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