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What is Payment Integrity? Payment Integrity is the process of ensuring healthcare claims are paid accurately, in the right amount,…

The Department of Health and Human Services Office of the Inspector General (HHS-OIG) conducted an audit to determine whether Medicare…

The Office of Inspector General (OIG) recently released a Medicare Part B audit titled “Medicare Could Have Saved an Estimated…

In a recent fraud indictment case, a provider was charged with over $3 million dollars1 in billing fraudulent claims for…

In a 2019, one of the largest Health Care Fraud schemes ever charged, federal investigations and prosecutions resulted in charges…

In a recent healthcare fraud case, from a short timeframe of November 2022 through May 2024, over $1.2 billion dollars…

by Steve Nesnidal, MD, CPC, AHFI Medical coding provides several important functions in healthcare. One of the main functions is…

by Steve Nesnidal, MD, CPC, AHFI A non-physician assistant at surgery–physician’s assistant (PA), nurse practitioner (NP), or clinical nurse specialist…

by Steve Nesnidal, MD, CPC, AHFI Fraud, Waste and Abuse (FWA) in Hospice is a significant US Healthcare problem. CMS…

by John Danza As a leader in the Medicare reference-based pricing (RBP) space, Context is frequently asked two questions: Our…

by Steve Nesnidal, MD, CPC, AHFI Dr. Steve Nesnidal of Context4 Healthcare, Inc. presented at the 2023 NHCAA Annual Training…

by Steve Nesnidal, MD, CPC, AHFI A common Fraud, Waste and Abuse (FWA) pattern detection involves monitoring for and analyzing…