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Our latest healthcare insights and perspectives

QUALITY AND STARS

Quality Decoded webinar series: 2025 CMS Advance Notice

Marge Ciancetta

Feb 20, 2024

Latest Content

QUALITY AND STARS

RISK ADJUSTMENT

3 interoperability updates for payers in 2024

Katie Devlin, DHSc, MS, CPHIMS

Feb 14, 2024

QUALITY AND STARS

RISK ADJUSTMENT

3 takeaways from the 2025 Advance Notice

Branka Sustic

Feb 8, 2024

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q4 2023

Erin Rutzler

Feb 6, 2024

FRAUD, WASTE, AND ABUSE

FWA Insights: Examining a suspicious volume of HCPCS codes

Melanie Poole

Jan 31, 2024

FRAUD, WASTE, AND ABUSE

How to sequence FWA investigations for greater impact

Erin Rutzler

Jun 7, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Flagging high-frequency telehealth claims

Erin Rutzler

Jun 1, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q1 2023

Erin Rutzler

May 4, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Prepay review leads to >$100K in projected annual savings

Erin Rutzler

Mar 28, 2023

FRAUD, WASTE, AND ABUSE

Webinar: Sequencing investigative activities for greater provider impact

Erin Rutzler

Mar 22, 2023

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q4 2022

Erin Rutzler

Feb 14, 2023

FRAUD, WASTE, AND ABUSE

FWA Insights: Navigating 2023 CPT code changes

Erin Rutzler

Jan 30, 2023

FRAUD, WASTE, AND ABUSE

Maintaining a strong and successful SIU in 2023

Erin Rutzler

Dec 14, 2022

FRAUD, WASTE, AND ABUSE

Webinar: Deter FWA in 2023 with the latest investigative strategies

Erin Rutzler

Nov 29, 2022

FRAUD, WASTE, AND ABUSE

Focusing on prepay FWA prevention at NHCAA's Annual Training Conference

Erin Rutzler

Nov 14, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q3 2022

Erin Rutzler

Oct 27, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Catching inappropriate billing within ASD services

Erin Rutzler

Sep 14, 2022

FRAUD, WASTE, AND ABUSE

SIU panel discussion: Best practices in healthcare payer FWA

Erin Rutzler

Sep 12, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: Spotting red flags in adult day care claims

Erin Rutzler

Aug 18, 2022

FRAUD, WASTE, AND ABUSE

FWA Insights: How to catch a DME scheme

Erin Rutzler

Jul 26, 2022

PAYMENT INTEGRITY

FRAUD, WASTE, AND ABUSE

White paper: Detecting and preventing FWA in behavioral health claims

Erin Rutzler

Jun 1, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q1 2022

Erin Rutzler

May 24, 2022

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q4 2021

Erin Rutzler

Jan 20, 2022

FRAUD, WASTE, AND ABUSE

What’s old is new again: 3 healthcare fraud trends to watch for in 2022

Erin Rutzler

Dec 2, 2021

FRAUD, WASTE, AND ABUSE

Preparing your payment integrity programs for 2022 and beyond

Erin Rutzler

Nov 8, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q3 2021

Erin Rutzler

Oct 26, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top fraud schemes of Q2 2021

Erin Rutzler

Jul 20, 2021

FRAUD, WASTE, AND ABUSE

Busted: The top healthcare fraud schemes of Q1 2021

Erin Rutzler

Apr 15, 2021

PAYMENT INTEGRITY

Busted: The top healthcare fraud schemes of Q4 2020

Erin Rutzler

Jan 25, 2021

COVID-19

PAYMENT INTEGRITY

Busted: the top COVID-19 healthcare fraud schemes

Erin Rutzler

Jul 13, 2020

COVID-19

PAYMENT INTEGRITY

Video: Preventing healthcare fraud, waste, and abuse before paying claims

Erin Rutzler

Jun 24, 2020

COVID-19

PAYMENT INTEGRITY

Coronavirus FWA: What health plans need to know

Erin Rutzler

Mar 23, 2020

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