#July Webinar 🚨 🧪Navigating Laboratory Schemes: Trends, Red Flags, and Best Practices. Please join us for another exciting webinar to discuss the ever-evolving world of lab schemes. Our presenters Lera Champagne-Andriani and Mandi Berg will walk you through key policies, top schemes that affect this specialty, and share tips on working these cases, including red flags in the data, medical reviews and on-site visits. Additionally, we will hit on GLP-1 drugs (ex: Ozempic), common schemes and data mining tricks to capture fraud, waste and abuse. Be sure to mark your calendars 📅 We look forward to seeing you! #HealthcareFraud #HealthcareServices #PassThroughBilling #Modifiers #UrineDrugTesting #GeneticTesting #MolecularPathology #ProcedureCode81479 #SIU #FWA #HealthcareInnovation #Ozempic #LabSchemes
Advize
Hospitals and Health Care
Orlando, Florida 33,535 followers
Healthcare & IT Audit & Advisory, Program Integrity, Compliance and Consulting for Payers, Providers, Legal & Government
About us
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.
- Website
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https://advizehealth.com
External link for Advize
- Industry
- Hospitals and Health Care
- Company size
- 51-200 employees
- Headquarters
- Orlando, Florida
- Type
- Privately Held
- Founded
- 2003
- Specialties
- 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, and CPC
Locations
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Primary
Orlando, Florida, US
Employees at Advize
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Jeanmarie Loria, MBA, PMP, CPC
CEO, Advize Health
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Brian Boyce
CEO, MHA, Risk Adjustment, Clinical Bioethics, Healthcare & Practice Operations Consultant. Aeromedical Air Force Vet, Entrepreneur, Human Rights…
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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
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Robin L. Kessinger
RN, CPC
Updates
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🌟 Embrace Clear Communication & Pure Listening 🌟 Inspired by The OG Jean, our CEO's grandmother, this week’s newsletter explores how empathy, real conversations, and clear communication shape our team and culture. Discover the profound impact of these values, with insights from a powerful excerpt of Journey to the Heart. Jeanmarie Loria, MBA, PMP, CPC | Chia Gemmato
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Advize reposted this
Advize Health Healthcare Fraud, Waste and Abuse-SME/Litigation and FWA Investigative Support/PBM/Healthcare Fraud/Retired Senior Special Agent HHS-OIG
As we continue to establish ourselves as a strong partner in the FWA space, we are looking to add several RN auditors to our team in supporting CMS. If you meet the criteria in the post, please consider applying. #siu #rncareers #rnlife #nursing #fwa #paymentintegrity #healthcarecompliance #healthcarefraud #hcca #ahla
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⭐ Meet Matt Kochanski, Director of Program Integrity at Advize. Matt's journey into healthcare fraud investigation began unexpectedly after grad school. Initially seeking a teaching career, his passion for solving puzzles and uncovering the truth led him to excel in roles at HHS, NASA, and UPIC. Driven by a desire to improve the U.S. healthcare system, Matt is committed to making a meaningful impact through program integrity work. Thank you for sharing your story, Matt! - - - I stumbled into the health care fraud arena. My then future mother-in-law worked for an OIG office. She suggested that I look into it as it wasn’t the “typical” government job. I had just finished grad school and was looking for a teaching position. Furthest thing from my mind was being a federal investigator. I applied, called a call within two days (timing is everything). I interviewed and was brought in as a Merit Scholar the following Monday. Even then, I had no idea what the job was. Why do I still do it? Two layers of reasons. First, when I was interviewed, my potential supervisor asked me, :You’re a history major, why should I hire you to be an Investigator?” My answer was that both positions seek the truth from whatever sources they can find. (I could really BS then). But, thinking about that – my love of solving puzzles, getting to the bottom of things, and finding the “truth” has motivated me my entre career – at HHS, NASA, the UPIC and here. But why healthcare? Because I believe we can do better. We are the richest country in the world but our healthcare system lags behind many other countries in many important areas. I want to do my part to help mitigate (if not solve) the problems that cause that. If the program integrity work that we do helps at all, I want to be a part of it for as long as I can. #VoicesOfHealthcare #HealthcareIntegrity #FraudPrevention #HealthcareHeroes #AdvizeHealth #ProgramIntegrity #HealthcareExcellence #HealthcareInnovation #MakingADifference #HealthcareLeadership
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The OIG Roundtable 🔥 Episode 86: The Trickle Down Effect of Changing Policies Eric, Matt and Wade discuss the importance of keeping an #SIU policies and procedures manual up to date and how variances in polices can reduce ROI, lead to issues in providing testimony in hearings and legal proceedings and the fact that priorities, while changing, should always be communicated clearly to the investigative team. https://lnkd.in/ejtAYtxH
OIG Roundtable 86: The Trickle Down Effect of Changing Policies
https://www.youtube.com/
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💡Turning the Cruise Ship: Advize's SIU Transformation Journey 🚢⚓️ 🔗Embracing our commitment to listening and collaboration, this monograph reflects our journey to enhance service quality and client ROI. At Advize, we start with 'Yes' to your unique needs, crafting tailored solutions for every challenge. 💪Together, we navigate towards greater transparency, stronger partnerships, and impactful results in healthcare integrity. By Matt Kochanski #SIUExcellence #ClientPartnership #TailoredSolutions #CaseStudy #ROI #ClearCommunication #WeStartWithYes #AdvizeListensToYourNeeds
Turning the Cruise Ship
Advize on LinkedIn
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Imagine a future where healthcare waste is a thing of the past. Picture a system where there's no resistance to eliminating inefficiencies. Envision a world where provider abrasion no longer exists. Think of everyone collaborating to eradicate fraud. Imagine if fraud, waste, and abuse in healthcare were completely eliminated. At Advize, we're obsessed with lowering the cost of healthcare in America. Helping our clients envision their future means making a positive impact on healthcare delivery and patient care. By minimizing improper payments and recovering payments already made that are determined to be fraudulent and/or wasteful, we positively impact the cost of delivering outstanding patient care. Imagine experiencing a transformed healthcare industry in the future. What would it look like to you? What methodologies and strategies would you implement? By Michelle Messick & Jeanmarie Loria, MBA, PMP, CPC #HealthcareTransformation #EliminateHealthcareFraud #LowerHealthcareCosts #PatientCare #HealthcareInnovation #FutureOfHealthcare #AdvizeHealth #HealthcareEfficiency
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We're #hiring a new Business Development Manager in United States. Apply today or share this post with your network.
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Ever wondered how advanced investigative skills can transform healthcare outcomes? We believe in the power of SIU excellence to effectively combat healthcare fraud. By empowering your team with meticulous attention to detail, we strengthen capabilities and ensure every healthcare dollar is used efficiently. 🔍 How can improved investigative techniques lead to lower healthcare costs? 📊 What impact does SIU excellence have on healthcare resource protection? We are committed to making this a reality. Today, we're thrilled to lead a training session for an SIU team! With a sole focus on lowering healthcare costs, we are dedicated to enhancing team development and providing advanced investigative skills. Topics covered include: 🔍 Interviewing and documentation in healthcare fraud investigations 📊 Data analysis and medical record reviews 📋 Vetting and reviewing complaints and new cases 🕵️ Investigation basis and investigative planning This really matters, so let's lower the cost of healthcare together—starting today! 📧 Email us at info@advizehealth.com 📞 Call us at 503-781-9051 | 407-583-7379 💻 Visit Our Website: https://advizehealth.com/ #AdvizeHealth #HealthcareFraud #SIUTraining #TeamDevelopment #HealthcareExcellence | Jeanmarie Loria, MBA, PMP, CPC | Dan Leslie
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We're #hiring a new Finance Manager in United States. Apply today or share this post with your network.