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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.
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A Review of Mohs Surgery Claims with Incorrect Coding May Reveal Fraud

  • December 1, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC There are a number of ways a dermatology claim for Mohs surgery can be…

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Context to Showcase FWA Solutions at NHCAA Conference in Dallas, TX

  • November 17, 2014
  • Blog

by Kate Armbruster Context4 Healthcare Inc. will showcase its Fraud, Waste & Abuse (FWA) solutions as an exhibitor at the National…

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Big Change This Fall! MUE Allows 2 E/M Codes Billed for the Same Day

  • November 3, 2014
  • Blog

by Margaret Klasa DC, APN BC In the past, Medicare has allowed only one Evaluation and Management (E/M) visit per…

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Why Quashing Kwashiorkor Overpayments is a Good Lesson for Any Payer

  • October 31, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC If you are seeing claims for the treatment of Kwashiorkor, you may want to…

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Tips to Modify Your Modifier Usage: Bundling & Unbundling Compliance

  • October 14, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC “Unbundling” is a hot topic within the healthcare community and is considered fraudulent if…

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Context to Make a Splash as Exhibitor at SIIA Conference – Phoenix, AZ

  • October 2, 2014
  • Blog

by Kate Armbruster Context4 Healthcare will showcase its payer solutions as an exhibitor at the SIIA 34th Annual National Educational Conference &…

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Are Your Clinical Lab Drug Screenings Free From Fraud?

  • September 26, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC Recently, a fraud scheme was uncovered in Virginia involving a substance abuse clinic and…

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The “X” Factor: 4 New Modifiers Will Define the Use of – 59 in 2015

  • September 11, 2014
  • Blog

by Margaret Klasa DC, APN BC On August 15, 2014, the Centers for Medicare & Medicaid Services (CMS) introduced four new Healthcare…

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Avoid Overpayment – Review Documentation for Outpatient Therapy Claims

  • September 11, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC Outpatient physical therapy claims present an area that has long been fraught with the…

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Drugs Used to Treat HIV Have Become Targets for Fraud Investigations

  • August 29, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC Antiretroviral drugs, used to treat Human Immunodeficiency Virus (HIV), have recently come under scrutiny…

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Context is on the Oregon Trail…to the Plexis 2014 Users Conference!

  • August 18, 2014
  • Blog

by Kate Armbruster Context4 Healthcare will showcase its FirstPass™ claim editing solution as an Integrated Partner exhibitor at the Plexis…

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Detect FWA Using Patterns in Procedure & Diagnosis Code Pairings

  • August 15, 2014
  • Blog

by Cindy Gallee, JD, RHIA, CHC Payers can detect fraudulent billing schemes by analyzing certain CPT codes that are used in conjunction…

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  • Home
  • About
    • About Us
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