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💡OIG Roundtable 119: The Medicare Policies Shaping Commercial Payors—Like It or Not Medicare policies don’t just stay in their lane. As CMS rolls out new National and Local Coverage Determinations (NCDs and LCDs), commercial payors are increasingly being influenced—sometimes in ways they never anticipated. These regulations are shifting reimbursement models, altering compliance expectations, and blurring the lines between government and private insurance. In this episode, Eric Rubenstein, MSCJ, CFE, Wade McFaul, and Matt Kochanski break down the direct and indirect ways CMS regulations are reshaping the commercial payor space. From unexpected policy overlaps to the long-term impact on fraud investigations, this discussion unpacks what industry professionals need to know to stay ahead. https://lnkd.in/emEiUyig #HealthcareFraud #SIU #MedicarePolicies #CMSRegulations #CommercialPayors #HealthcareCompliance #InsuranceIndustry #FraudPrevention #HealthcareInvestigations #PolicyImpact #MedicalBilling #ReimbursementRules #ProgramIntegrity

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🚩THESE CODING MISTAKES ARE COSTING YOU THOUSANDS! Are you unknowingly throwing money away? One simple mistake in DME or Chronic Care Management (CCM) coding can lead to denied claims, audits, and even fines. 🚨The most painful mistakes you might be making right now: - Using time-based CPT codes incorrectly → If your documentation doesn’t prove the time spent, kiss that reimbursement goodbye. - Failing to meet DME documentation requirements → Without airtight records, your claims WILL be rejected. - Unbundling or overcoding services → This can trigger fraud investigations (yes, even if it was unintentional). - Missing required signatures or provider attestations → No signature? No payment. - Billing for services that lack medical necessity → One flagged claim could mean a full-blown audit of your entire practice. - Ignoring state, federal, and payer-specific policies → The rules are changing in 2025. Are you prepared? If any of these sound familiar, you NEED to attend this webinar. What You’ll Learn: ✅ How to fix these errors before they catch up to you. ✅ Compliance strategies to protect your revenue and reputation. ✅ What OIG, CMS, and MACs are cracking down on in 2025. Don’t wait until it’s too late—your revenue is at stake. Date: Tue (3/25) | 1 PM ET Register Now: https://lnkd.in/ghwXUNse Speakers: Carey Mead | Mandi Berg #MarchWebinar #MedicalBillingMistakes #DeniedClaims #HealthcareCompliance #DME #CCM #BillingErrors

🔍Optimize Your Compliance & Program Integrity with Advize! Managing SIU and Payment Integrity challenges while controlling costs is no easy task. We help healthcare organizations streamline operations, eliminate inefficiencies, and maximize ROI with expert-led consulting and advisory services. - Identify & Reduce Duplicative Efforts - Enhance Collaboration Across Departments - Improve Provider Education & Reduce Abrasion - Optimize Compliance & Fraud Prevention Strategies - Achieve Faster Overpayment Recovery With our scorecard assessment and DMAIC methodology, we deliver measurable improvements that drive efficiency and savings. Our team of highly qualified investigators, auditors, and compliance experts is ready to support your organization’s success. Let’s build a stronger compliance strategy together! Contact us today. 📩 jloria@advizehealth.com #HealthcareCompliance #SIU #PaymentIntegrity #FraudPrevention #AdvizeHealth

🚩 Have you ever been told your life would never be the same again? 🚩 That you'd never live as you once did? 🚩 What if the first opinion you hear isn’t the final truth? From being told you’ll never walk again after a simple injury to facing terminal illness with no options left, extreme diagnoses can be devastating—but they’re not always the last word. Misinformation runs rampant—even from the professionals we trust. That’s why it’s crucial to question, seek alternatives, and advocate for the care you deserve. In this blog, we’ll explore how to take control of your health journey, challenge the system, and make decisions that truly benefit you.

🚨 How to Avoid Phishing Scams 🚨 By Erik Consorsha | Advize's Chief Information Officer Another day, another phishing attempt—but luckily, we dodged the scam! Now, we’re sharing our best strategies so you can stay one step ahead. Stay sharp, spot the red flags, and don’t let scammers reel you in! 🎣🚫

10 Years 😍 Still Smiling! Still Celebrating! #TeamWork

Self-Care for Busy People Mondays and Tuesdays are packed. Emails, deadlines, back-to-back meetings… But self-care doesn’t have to take hours. Sometimes, 15 minutes is all you need. Join us for a quick Tuesday Stretch—a simple, guided session to shake off tension, reset your posture, and start the week feeling better. 📅 Tuesday | 15 minutes | Just show up Your to-do list isn’t going anywhere—but you’ll tackle it with more energy and less stress. Who’s in? 💙 #SelfCareMonday #AdvizeHealth #StretchBreak

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Not doing anything today? You are cordially invited to join Robyn Marie Alvarado, CPC, CPMA with this tremendous idea #DaysGoneBy #podcast Eric | Jaysen | Wade | Matt | J Stone | #sundayfunday #OIGRoundtable