FWA Briefs

Find news and solutions for healthcare payers and providers. Recognize and avoid potential fraud, waste, and abuse scenarios. Real-time clinical claim editing are analyzed to maximize provider reimbursements.

Overutilized High-level Drug Testing: Small Fees, Large Overpayments

  • Steve Nesnidal, MD, CPC, AHFI
  • Nov 17, 2023
  • Comments
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Dr. Steve Nesnidal of Context 4 Healthcare, Inc. presented at the 2023 NHCAA Annual Training Conference on Overutilized High-level Drug Testing, focused on Small Fees with Large Overpayments. Dr. Nesnidal goes into depth about specific cases where aberrant providers intentionally billed a higher amount of the higher-level codes.

Monitor Potential FWA: Overutilization of High-Level Codes

  • Steve Nesnidal, MD, CPC, AHFI
  • Sep 13, 2023
  • Comments
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In our latest blog, we discuss a recent OIG report that found Medicare could have saved millions of dollars by monitoring providers who billed the highest reimbursable codes. It shows how certain code descriptions were miscounted by providers, causing higher reimbursements that weren't owed. Click below to learn and read more.

Combating Overutilization of Healthcare Resources

  • Steve Nesnidal, MD, CPC, AHFI
  • Feb 04, 2019
  • Comments
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Overutilization in Healthcare is a problem which has been estimated to cost in the range of hundreds of billions of US dollars every year. Despite historically spending more than double per person on healthcare than the average developed country, our outcomes have not been significantly better.

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