This Valentine’s Day, we have decided to share some vendor neutral love with our technology vendor friends. Check out our Love Letter to Technology Vendors to learn 5 lessons that we think can help you build a better presence in the FWA industry.
Read MoreIntegrity Advantage helped a state review home health claims for FWA. This article highlights the main findings that you can look at when reviewing home health claims.
Read MoreIn the final video in this series, Jala walks us through Pitfall #3 of the Top 3 Program Pitfalls and how to Overcome Them. This pitfall focuses on the lack of organizational buy-in and how that can be impacted with communication with other business units.
Read MoreContinuing with the Top FWA Program Pitfalls series - Pitfall #2 is assuming that compliance ensures FWA program success. In this video, Jala discusses why this is not always the case and how you can overcome this pitfall.
Read MoreIn this video, Jala Attia elaborates on Pitfall #1 in Top 3 FWA Program Pitfalls and How to Overcome Them. Pitfall #1 focuses on missing the signs of a struggling program and how to identify these challenges.
Read MoreWith the sheer volume of complaints and referrals that make their way to the SIU, it’s no wonder many teams are overwhelmed with case backlogs. Check out our most recent article where we share how you can improve SIU effectiveness in 3 easy steps.
Read MoreIn our years of doing program assessments, we've learned a lot. In this video we recap the Top 3 Program Pitfalls that we covered during a recent webinar.
Read MoreIntegrity Advantage was thrilled to participate in the National Health Care Anti-Fraud Association’s Annual Training Conference in Orlando during the week of November 14th.
Read MoreWe’ve been asked what we mean when we say #FreeTheSIU? Check out our latest blog post to better understand why we are pushing health payers to #FreeTheSIU!
Read MoreHave you ever wondered whether you should have a coder or a nurse perform a medical review? You are not alone. In this article, a few of Integrity Advantages nurses and coders share the different, yet valuable perspectives that that each bring to the table when doing a medical review and how to leverage these insights for better investigative outcomes.
Read MoreIntegrity Advantage had a fabulous time hosting our first booth at the National Association of Medicaid Program Integrity, or NAMPI, conference. One of our Rockstars, Cailin Kehoe, shares her impressions as a first-time attendee of this conference.
Read MoreApplied Behavior Analysis (ABA) cases have been a hot topic - even more so since the pandemic. Many plans are finding that these investigations and medical reviews are far more complex than typical FWA cases and require great collaboration among investigators and clinical staff. Download our article to learn the best ways to tackle the ABA cases in your pipeline.
Read MoreMost medical review teams do not have an active role in sampling. However, understanding that the review of an allegation may require an investigator to request records in a certain manner can make the difference between a strong case and one that is indefensible. But how do you destress the sampling process? Having a clear process in place is just one step. You really should include the medical review perspective before you sample. This article shares some key considerations to include in your sampling process to ensure an effective fraud, waste and abuse medical review.
Read MoreMedical reviews are a critical part of many FWA investigations. It isn’t enough to simply look at them as line-by-line results. Drive more value by kicking it up a notch. In this article, we share 5 ways to take your medical review process to the next level.
Read MoreMost FWA programs rely on recoveries and savings as the measure of success. But there is another critical component that's a hidden risk and amounts to big dollars: Prevented Losses. We are bringing prevented losses to the forefront, not just in concept, but also in terms of the financial impact on healthcare payment integrity. This article discusses challenges that continue to exist and what we need to do as an industry in order to continue to evolve the value of our FWA programs.
Read MoreMany investigative teams fear being expendable. Some resist new technology capabilities because they feel threatened. This fear is rooted in process - steps they are expected follow when working investigations. This video prompts the question - are you building a team of thinkers or a team of robots?
Read MoreOne common question we all grapple with is how long we should leave a provider on prepay? Watch this video to learn some of our tips related to prepay monitoring of providers and what you should do if you aren't sure how to handle a provider that consistently bills inappropriately.
Read MoreOutsourcing is often thought to be a dirty word. But don’t be fooled - outsourcing can be a cost effective, high impact investment into the success of your team. Since many of you know this is precisely the business we are in - we decided to discuss some common misconceptions we’ve heard over the years and the many lessons learned as a result.
Read MoreSurviving in the world of FWA is somewhat like surviving in the wild. Without some essential elements, your shot at success decreases. Don’t go on the journey alone. Download Integrity Advantage’s SIU Survival Guide and read about ten critical elements that you can implement to set up your FWA program for success. In it, we share tips and lessons learned from many years of hands-on experience working with payers of various sizes and different lines of business. Take our guide with you on your journey and reimagine the value of your FWA Program!
Read MoreWhen holding your FWA team accountable for identifying enterprise risks, setting the goal is only the first step. Many leaders struggle with step 2 - which is "how" do we measure this? In this video, Jala talks about the key components to include when considering the goal of risk identification.
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