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.

Medicare Advantage Plans Under the FWA Microscope

  • Margaret Klasa DC, APN BC
  • Jun 29, 2017
  • Comments

HEALTHCARE  is again the most popular topic for the past few weeks.  Even friends that don’t know much about the industry have asked: what’s going on with Medicare?  Apparently, recent allegations of high dollar medical fraud have raised concerns about Medicare Advantage Plans and Payment Integrity.  One law firm pointed out that this is just the start.  “DOJ’s big settlement — $16.7 million for risk adjustment “upcoding” ...

Payers Use UCR Data to Drive Behavioral Health Outcomes

  • Margaret Klasa DC, APN BC
  • May 10, 2017
  • Comments

Context's UCR data can help with Behavioral Health population health management. Behavioral Health issues compound the chronic condition scenario. The United States spends more on mental health and addiction than on any other medical condition including heart disease, trauma, and cancer.

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