How to collect forensic evidence in an interview for a healthcare audit.
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Tag Archives: Investigation
Investigation Targets Medicaid Transportation Fraud in the North Country
13 people were arrested this week as part of a federal and state investigation into Medicaid fraud allegedly committed by the owners and operators of medical transportation companies based in Essex County.
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Aetna Under Investigation for Medical Review Policy
Aetna is under investigation in California for allegedly not following protocol when making coverage decisions. One Aetna member, Gillen Washington, 23, claims it nearly cost him his life. Washington is suing Aetna for breach of contract and bad faith, according to CNN. Case for the Plaintiff Washington, who has common variable immunodeficiency (CVID), claims Aetna […]
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Confidently Appeal a Special Investigation Unit Refund Request
Communication is essential to a smooth appeals process. Your practice was the subject of a special investigation unit (SIU) audit, and now the payer is asking for a refund. You have two choices: pay or appeal. If you disagree with the findings, the smart choice is to meet with the payer, appeal the findings, and […]
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