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!

⚾Just as we uncovered healthcare fraud in basketball a few years back, the recent scandal involving Shohei Ohtani's former translator serves as a stark reminder of the importance of trust—both in sports and healthcare. 🎯The Reality of Betrayal When trust is broken for personal gain, it can ruin lives and reputations. 🎯Case in Point Take the case of Ippei Mizuhara, who pleaded guilty to illegally transferring $17 million from Ohtani's account. U.S. Attorney Martin Estrada stated, “The extent of this defendant’s deception and theft is massive.” Mizuhara abused his position of trust, using Ohtani’s password and even impersonating him to fuel a gambling addiction. 🎯This isn’t just a sports story; it echoes in healthcare too. Just like Mizuhara exploited a system meant to support others, healthcare fraud involves people taking advantage of trust through actions such as: - Billing for fake services - Submitting false claims 🎯Universal Truths About Fraud - Fraud doesn’t just impact the victims: It affects everyone involved, tarnishing reputations and shaking our trust in the systems we rely on. - Integrity is essential: Upholding trust is crucial for healthy relationships in any industry. 🎯Taking Action Together By recognizing the signs of fraud and standing up for what’s right, we can protect ourselves and our communities. Together, we can create a fairer and more honest system. #HealthcareFraud #SportsIntegrity #TrustMatters #FraudPrevention #EthicsInHealthcare #Accountability #IntegrityFirst #ProtectYourself #CommunityTrust #StayInTheGame #WorldSeries2024

#OctoberWebinar 🚨 💡The Shift from Managing a Large Payment Integrity Department to a Smaller National Plan with VP of Payment Integrity at CareSource Kelly Anderson Eric Rubenstein, MSCJ, CFE and Kelly Anderson discuss the challenges of moving from a large, national payment integrity system to a small, Medicaid focused plan, working regionally. #PaymentIntegrity #LeadershipTransition #HealthcareManagement #MedicaidPlans #ProfessionalGrowth #RegionalPlanning #PeopleProcessTechnology #HealthcareFraudPrevention #TeamBuyIn #AdvizeHealthWebinar

🌟 It’s Happening Today! 🌟 If you haven’t registered for our October Webinar, there’s still time to join us live or sign up to catch the recording later! Join industry leaders Eric Rubenstein, MSCJ, CFE from Advize and Kelly Anderson, VP of Payment Integrity at CareSource, as they explore the shift from managing large payment integrity teams to regional, Medicaid-focused plans. 🚀 Expect insights on: - Navigating Payment Integrity in smaller, focused markets - Building buy-in in changing leadership landscapes - Mastering the balance of people, process, and technology for sustainable growth Don’t miss out on this chance to learn from the best in SIU, Leadership, and KPI-driven growth in payment integrity! See you there or catch the replay at your convenience. 🔗https://lnkd.in/ezJsgJ-R #OctoberWebinar #SIU #Leadership #KPI #PaymentIntegrity #Healthcare

🚨 Paging Dr. Fraud! 🚨 Healthcare providers, do you know how fraud impacts your practice and the healthcare system? Our latest blog breaks down the essentials of healthcare fraud, OIG, CMS, and how Advize can help protect your practice and patients. Dive in and stay compliant! 💡 #HealthcareFraud #Compliance #AdvizeHealth

🎊 Exciting News at Advize! We are delighted to announce the promotion of David Bolden, CPC, CPCO, to Audit Manager! Since joining Advize, David has proven to be a key asset to our team, consistently demonstrating his expertise in healthcare coding and compliance along with a commitment to collaboration. His efforts have included spearheading critical audit reviews, enhancing our compliance frameworks, conducting insightful training webinars, and nurturing a culture focused on continuous improvement. David's commitment to teamwork and clear communication has not only elevated our operational standards but has also inspired his colleagues to strive for excellence. As #AuditManager, he will play a pivotal role in driving essential projects forward, ensuring that our clients receive the top-tier service and expertise they expect from Advize. Join us in congratulating David on this well-deserved promotion and celebrating his ongoing achievements! 👏 Learn more about his promotion on our website: https://lnkd.in/gaaihwsM #AdvizeLeadership #Teamwork #AdvizeHealth #HealthcareExcellence #PromotionAnnouncements #HealthcareInnovation

🎯As a former agent, Eric Rubenstein, MSCJ, CFE always found himself facepalming at some of these insights. However, these recommendations are more than just a laugh—they offer payors an essential opportunity to review their policies and ensure alignment with effective payment operations. “At Advize, our team brings unparalleled expertise in OIG operations. As former criminal investigators, we understand the nuances of these issues from the inside out.” This insight allows us to help healthcare organizations not only comply but excel in their payment integrity efforts. 🔗 Check out the Recommendations Tracker from HHS-OIG to explore how we can drive positive change in healthcare together: https://lnkd.in/eJ_mTDvD #ahla #hcca #paymentintegrity #healthcarefraud #healthcarecompliance #fwa

#FridayMood 🤣 Advize PSA: Let's circle back. #ActionOverJargon #FridayFun 📽️: ClickUp

#TheOIGRoundtable 100th Episode 🥂 🙌It’s finally here! For the 100th episode special of the OIG Roundtable podcast, Jeanmarie Loria, MBA, PMP, CPC, along with several surprise guests, invades the show for an exciting and unexpected twist! The episode dives into lively conversations about healthcare compliance, fraud prevention, and regulatory oversight, featuring stories and insights from some of the top voices in the field. This milestone episode celebrates the journey so far, adding humor, surprise appearances, and a deep dive into industry challenges, making it a must-listen for long-time fans and new listeners alike! A heartfelt thank you to our incredible guests for their expertise and to our loyal audience for your unwavering support. 🚨Don’t miss this celebration—here’s to the next 100 episodes! 🎉 https://lnkd.in/eQT9QFaM Eric Rubenstein, MSCJ, CFE | Jaysen Eisengrein, MBA, PgC, SAC (RET) | Matt Kochanski | Wade McFaul | Dan Leslie | Sonal P. | Carey Mead | David Bolden, CPC, CPCO | Julie Smallwood | Julie Janeway | Omar Pérez Aybar, MBA | Susan Frisco | Lisa D. Taylor | Jim Cox | S. Scott Ward, AFHI, CFE #OIGRoundtable #AdvizeHealth #InvestigationExcellence

🎉 OIG Roundtable 100th Episode: Featuring Matt Kochanski 🎉 We’re excited to feature another of our incredible hosts, Matt, who shared powerful insights on the core of healthcare fraud investigations. In his own words, Matt breaks it down simply: "You have to answer two questions: What were they doing? And did it violate the rules or laws?" His vast experience reminds us that while the structure of an investigation may seem straightforward, true excellence comes from taking the right investigative steps and ensuring consistency in approach—because every detail matters when you're on the witness stand or facing an appeal. With a 35-year career spanning roles at HHS OIG, NASA OIG, and as a CMS program integrity contractor, Matt’s leadership and dedication to combating healthcare fraud have made a profound impact across the industry. We’re honored to have him as part of our team at Advize Health. Listen to his invaluable insights, and don’t miss more of his thoughts in our 100th episode! #OIGRoundtable #100thEpisode #HealthcareFraud #Leadership #Excellence #Integrity