Joseph Rivet, Esq.
Joseph Rivet, Esq., founder of Rivet Health Law, PLC in Norton Shores, Michigan, occupies a unique niche in health care reimbursement, beginning with a career in emergency medicine coding and continuing with increasing levels of responsibility and expertise as a manager in varied health care provider and payor settings.
The broad spectrum of Joe’s health care experience includes inpatient and outpatient coding, teaching-physician services, integrated healthcare delivery systems, evaluation and management (E/M) coding, emergency medical services (ambulance) coding and billing, and Medicare and Medicaid rules. Joe’s extensive payor and provider coding compliance experience underscores his depth of knowledge with respect to ever-changing regulations and sometimes perplexing Medicaid jurisdictional variations.
Before Joe became an attorney, he worked in numerous health care settings, including community hospitals, large medical groups, and one of the nation’s largest integrated delivery systems. A coding expert and educator whose responsibilities have included ensuring coding and revenue cycle integrity, Joe has served as the lead coding instructor at the U.S. Department of Justice Medicaid Integrity Institute, which provides training in fraud investigations, data mining and analysis, provider enrollment, managed care oversight, emerging trends, and case development to help protect the integrity of the Medicaid program.
Joe has led the fraud, waste, and abuse (FWA) divisions of two large health plans. The depth and breadth of his payor experience provides invaluable insight for providers with respect to payor audits, the claims adjudication process, appeals, payor policies, managed care contracts, and audit operations.
Joe’s healthcare reimbursement experience includes response management during numerous federal (e.g., Target Probe and Educate (TPE), Recovery Audit Contractor (RAC)), state Office of Inspector General (OIG), and private payor audits including Special Investigation Unit (SIU), Aetna ® , WellCare ® , Centene ® and many others. A nationally recognized coding, billing, reimbursement, and regulatory expert, Joe frequently explains the nuances of these topics at national and regional healthcare conferences and seminars.