🚨 Ready for 2025? 🚨 We’re wrapping up 2024 with a must-attend webinar: Insights and Trends Shaping Healthcare in 2025, featuring David Bolden, CPC, CPCO, and Mandi Berg. This is your chance to gain valuable perspectives from both an investigator and auditor’s point of view—essential for anyone navigating the complex healthcare landscape. 💡 What challenge have you faced this year in healthcare? Is it keeping up with evolving regulations, managing complex data, or improving your team’s efficiency? 🌟 What are your priorities for 2025? Are you focusing on leveraging technology to improve patient care, enhancing compliance strategies, or tackling fraud prevention? We’ve learned valuable lessons from situations like navigating data discrepancies during audits, adapting to shifting healthcare compliance standards, and streamlining investigative processes to detect fraud more effectively—and we’ll be sharing these insights with you. ✨ Whether you can attend live or not, be sure to register now—a recording will be available for all registrants. Don’t miss out on insights that can help you thrive in 2025! 🔗https://lnkd.in/eerFreVi #HealthcareTrends2025 #DataAnalytics #AdvizeHealth #HealthcareFuture #DecemberWebinar
Advize
Hospitals and Health Care
Orlando, Florida 45,949 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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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
Updates
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OIG Roundtable 104: Can Legal Shifts Derail Investigations? Are you ready to rethink everything you thought you knew about investigations? In this episode, Eric Rubenstein, MSCJ, CFE, Matt Kochanski, and Wade McFaul dive deep into the groundbreaking 2023 SCOTUS SuperValu decision that’s redefining the game. Objective vs. subjective knowledge under the FCA is no longer just legal jargon—it’s a seismic shift that could completely alter your investigative approach. This isn’t just a conversation; it’s a wake-up call. Missing out on these critical insights could leave you unprepared for the next big challenge. Are you keeping up, or are you falling behind? 🔗 Watch now and stay ahead: https://lnkd.in/g9wY3BwM
OIG Roundtable 104: Keeping up with legal decisions can affect investigative direction
https://www.youtube.com/
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💥 10 YEARS AGO 💥 We unveiled our new brand in #Dallas at the NHCAA INSTITUTE FOR HEALTH CARE FRAUD PREVENTION INC Annual Training Conference! 🎉 A decade later, we’re proud to reflect on how far we’ve come while staying true to our core values: ✅ Woman-Owned ✅ Significant Cost Reduction ✅ Superior Quality ✅ Unique Blend of Expertise ✅ Outstanding Service Of course, some things have changed... like our ridiculous growth 🚀, the addition of incredible team members (starting with Eric!), and signing new clients while continuing to honor and appreciate our loyal partners of 20+ years. Together, we’ve built something truly special for over two and a half decades! WOW! Thank you, Jeanmarie Loria, MBA, PMP, CPC, for sharing this beautiful reflection. Here’s to continuing to make a difference in healthcare fraud prevention and beyond! 💙 #NHCAA #ATC2024 #WomanOwned #Healthcare #FWA #PaymentIntegrity #Claims #Audits
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Thank you all for your amazing recommendations! 🙌 Our list so far includes spots like The Court of Two Sisters, Coterie Restaurant & Oyster Bar, Ruby Slipper Cafe, and GW Fins. Keep telling us about your favorite #NewOrleans spots—we can’t wait to experience the best of NOLA! 🍽️ #NOLA #NewOrleansEats #FoodLovers #NOLAFood #NHCAA #ATC #HealthcareTraining #TheBigEasy #AdvizeHealth #ExploreNOLA #CulinaryFavorites
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⚠️Modifier 59: Do I Need It – Or Better Yet – Should I Use It? 🎟️Welcome to Advize's Coding Insights Series! Over the next three weeks, we’ll be sharing a series of blogs designed to help coders navigate the nuances of medical coding with clarity and confidence. 🤔Have you ever faced challenges when deciding whether Modifier 59 is appropriate for your claims? Senior Clinical Auditor Stefanie Lawrence breaks down the essential dos and don'ts of Modifier 59, including when it's acceptable to use—and when it’s not. Keep an eye out for more helpful insights in the coming weeks! #Modifier59 #MedicalCoding #HealthcareCompliance #CodingInsights #ClinicalAuditing #AdvizeHealth #CodingTips #HealthcareProfessionals #MedicalBilling #ModifierUsage #CodingBestPractices
Modifier 59: Do I Need It – Or Better Yet – Should I Use It?
Advize on LinkedIn
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🚀Need to Optimize Your Medicaid Program Integrity? Start with SIU Excellence. At Advize, our partners have uncovered over $15M in overpayments since April 2024—thanks to proactive SIU reviews and strategic insights. And with several ongoing reviews, more savings are expected. As medical costs continue to rise, optimizing your SIU team’s effectiveness is crucial. With the growing financial pressures on #Medicaid programs, our approach delivers actionable results that help combat the rising cost trend. Ready to take control of your recoveries and reduce costs? Let’s talk about how Advize can help. #MedicaidProgramIntegrity #SIUExcellence #CostSavings #AdvizeHealth #FraudPrevention #NHCAA
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Last week, we had the privilege of hosting a thought-provoking webinar titled “Tools of the Trade: Best Investigator and Auditor Hacks.” Our panelists, Jessica Rodriguez, SIU Investigator, and Rebecca Figueras, Documentation Auditor, shared their expertise on the essential tools, techniques, and strategies that empower healthcare investigators and auditors to succeed in today’s dynamic landscape. 🎯This blog highlights the key takeaways, audience questions, and expert insights from the session. For those of you who couldn’t attend, don’t worry—we’ve got you covered. 🎥 Watch the full recording by following the link at the bottom of our blog. #HealthcareCompliance #FraudPrevention #AuditingExcellence #InvestigationTools #DataIntegrity #SIUInsights #HealthcareLeadership #WebinarRecap #AdvizeHealth #ProfessionalDevelopment
November Webinar Recap
Advize on LinkedIn
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Advize reposted this
💥 10 YEARS AGO 💥 🥳 Advize unveiled our new brand in #Dallas at the NHCAA INSTITUTE FOR HEALTH CARE FRAUD PREVENTION INC Annual Training Conference! Since then, not many things have changed*. Our differentiators are still: ✅ Woman-Owned ✅ Significant Cost Reduction ✅ Superior Quality ✅ Unique Blend of Expertise ✅ Outstanding Service *changed!?! Well, other than ridiculous growth - That happened. AND we've added some of the best hires (starting with Eric)! Signed some awesome new clients (in addition to our solid 20+ year clients who we appreciate very much) to make us an even better company for two and a half decades now! WOW! #NHCAA #ATC2024 #womanowned #healthcare #CPC #SIU #FWA #paymentintegrity #coordinationofbenefits #claims #audits #charts #cob
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We're #hiring a new Senior Data Fraud Analyst in United States. Apply today or share this post with your network.
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🚨That’s right—we said it🎤 The KPIs many SIUs rely on today are outdated and, frankly, ineffective in addressing the realities of modern healthcare fraud. 😖 Recovery rates? They only tell part of the story. 😔 Case closures? What about the quality and long-term impact of those cases? 😴 What about the real-time detection of fraud or measuring operational efficiency? 🪦 These metrics worked a decade ago, but they don’t reflect today’s challenges: real-time detection, operational efficiency, and fraud prevention. At Advize, we believe it’s time to rethink how we measure success in Special Investigation Units. Our modernized KPIs focus on: 📊 Real-time fraud detection 🎯 Measurable case outcomes with tangible impact 💸 Operational and financial efficiencies that actually move the needle The question is: Are we too comfortable with the status quo to demand better? 📄 Dive into our approach with our white paper: Modernizing Performance Metrics for Your SIU https://lnkd.in/e4SmpBub 💬 Agree or disagree? Let’s talk about it when you get to NOLA for ATC 2024—we’d love to connect. See you soon! #SIU #KPIs #FraudPrevention #AdvizeHealth #HealthcareInnovation #NHCAA #ATC2024