Advize

Welcome to Advize Health! 👋As we celebrate our growth to over 40,000 followers, we want to extend a warm invitation to those who are new here. If you’re curious about who we are and what we do, this blog is the perfect place to start. We invite you to explore our vision, mission, and commitment to making healthcare better. Our focus is on being patient-centric and affordable, ensuring that patients receive the care they need while helping providers and plans operate effectively. Thank you for joining us on this journey—we're excited to share our story with you!

❤️🩹In healthcare, the choices we make—whether big or small—can have a lasting impact on our careers, the patients we serve, and the industry as a whole. 🚨Every decision, from the daily operational tasks to the larger strategic moves, plays a crucial role in shaping the future of healthcare. 🎯In this blog, we’ll explore how seemingly small, pivotal choices can lead to profound change, how the people who support us along the way make a difference, and why reflecting on these moments is essential for both personal and professional growth. 🔥Discover how the right decisions can help build a healthcare system founded on integrity, accountability, and continuous improvement.

🎙️The OIG Roundtable Episode 98: Data Always Fails Us! Eric and Wade delve into the findings of a revealing May 2024 OIG-OEI study on Durable Medical Equipment (DME) spanning from 2018 to 2020. This study highlights an astonishing reality: over $1 billion was paid for DME during this period. But what raises eyebrows even more is the behavior of a single doctor—a radiologist in California—who ordered over 20,000 DME products for patients across 44 states. This statistic presents a puzzling scenario that underscores the importance of scrutinizing data in healthcare. Join us as we unpack the implications of this study and discuss the broader challenges surrounding data integrity and utilization in our healthcare system. How can we ensure that our data serves us effectively rather than leading us astray? Tune in to gain insights that could reshape your understanding of DME practices and the importance of accountability in healthcare. 🔗 https://lnkd.in/ew-kCckT #OIGRoundtable #DataIntegrity #HealthcareInsights #DME #HealthcareAccountability

🚨 300+ Healthcare Professionals Empowered 🚨 At Advize, we're shaping the future of healthcare compliance! Recently, Eric Rubenstein, MSCJ, CFE and April Cameron led an impactful training session for over 300 attendees, addressing the 70% error rates uncovered in our Medicaid reviews. This session went beyond meeting regulations— it empowered change, ensuring healthcare integrity and accountability. Curious about how compliance training can prevent costly penalties and drive real results? Read our latest blog for all the insights! 💡 #ComplianceLeadership #HealthcareTransformation #Advize #Accountability #HealthcareCompliance

Thinking of Our Floridian Colleagues! 🙏❤️

Over our 22+ years at Advize, we’ve encountered countless experiences that have transformed our understanding of leadership within our team. These moments have revealed hidden strengths and highlighted our collective commitment to growth and excellence. We’re proud to have identified five key moments that exemplify our leadership potential and showcase the incredible work we do together. 🏆Here’s a celebration of our triumphs!

🚨Audience Help Needed🚨 What do you think is the most important aspect of an Effective Compliance Program? Please vote below ⬇️ - - - The importance of an effective compliance program cannot be overstated in the fight against FWA in healthcare. 🎯Recently, our prepay reviews for a large Medicaid plan client revealed an alarming error rate of approximately 70%—the potential overpayments from these errors can be substantial. 🎯Engaging in third-party reviews positions providers much better to withstand audits and investigations. Remember, the Affordable Care Act mandates that all providers participating in Medicare and Medicaid implement an effective compliance program. ⚖️Failing to do so can result in significant penalties, with states like New York imposing fines of up to $5,000 per month for non-compliance.

At Advize, we know that fraud, waste, and abuse continue to affect the healthcare industry, and we are driving the change that’s needed. The current cycle harms not only healthcare providers but also our economy, and we are actively working to break it. We care deeply about the people we serve, and every day, we commit ourselves to "fighting the good fight" by holding the industry accountable and ensuring integrity in everything we do. What’s often overlooked is the lack of true accountability in healthcare. Too many times, we treat the symptoms rather than addressing the root cause. We are challenging the mindset of “It’s always been this way” to create real, lasting change. This issue impacts all of us. Even though we at Advize are more aware, none of us are shielded from the flaws in the system. That’s why we are leading the charge toward a more accountable and efficient healthcare system. Thank you, David Bolden, CPC, CPCO, for expressing these powerful truths. Together, we are making a difference. #AdvizeHealth #HealthcareTransformation #Accountability

Tip #4: Accurate Drug Billing with the JZ Modifier Starting July 1, 2023, Medicare requires the use of the JZ modifier on claims for single-dose containers with no discarded amounts. For proper drug billing, ensure the following: 🎯Non-Discarded Claims: - Use the drug’s HCPCS code. - Apply the JZ modifier to indicate no waste. - Include the number of units administered. - Submit pricing based on the amount given. 🎯Discarded Claims: Submit two claim lines: - Line #1: Drug administered (no modifier, units given). - Line #2: Drug wasted (JW modifier, units wasted). 🚨Why it Matters: This process ensures accurate reporting and reimbursement for both administered and discarded drugs, optimizing resource management and compliance. Stay tuned for more insights on best billing practices! #HealthcareFraudPrevention #BillingCompliance #MedicalBilling #MedicareUpdates #JWModifier #JZModifier #FraudAwareness #DrugWasteManagement #HealthcareEducation #AdvizeHealth #SIU #HealthcareCompliance #MedicalCoding #FraudDetection #AccurateBilling

Our commitment goes beyond consulting—it's about making a difference. We care deeply about: - Helping you, your business, and each other succeed. - Educating and empowering others to become more self-aware, competent, and efficient—working smarter, not harder. - Protecting the innocent while uncovering those who aren’t upholding the values of integrity. - Our country and the benefits it provides, working tirelessly to safeguard its systems and services. Thank you, Robin L. Kessinger, for articulating our mission and vision so well 💖 You inspire us all to strive for excellence in everything we do. Together, we aim to elevate healthcare and protect what matters most. #AdvizeHealth #HealthcareExcellence #Integrity