Author Archives: Joseph Rivet
When Sports Stardom Meets Criminal Liability: Compliance Lessons from a $197M Medicare Fraud Case
A federal jury recently convicted former NFL player Joel Rufus French of orchestrating a massive [...]
Wire Transfers: Small Process Gaps, Big Financial Risk for Physician Practices
Wire transfers are part of modern medical practice operations. Practices routinely send wires for real [...]
New Credentialing Timelines Could Transform Provider–Insurer Relations
Michigan lawmakers are moving to overhaul health care provider credentialing timelines—and insurers, hospitals, and clinicians should be [...]
Office Manager Sentenced in $1.76 Million Medicaid Fraud Scheme
The Pennsylvania Office of Attorney General has won a significant victory in the fight against [...]
Remote Patient Monitoring: What It Is and Why It Matters
Remote Patient Monitoring (RPM) is becoming one of the most valuable tools in modern health [...]
Alleged Abuse of the No Surprises Act IDR Process – Providers and Billing Companies Be Warned
What a new federal lawsuit says about the growing strain on No Surprises Act arbitration—and [...]
Insurance Verification – It’s More than Scanning an Insurance Card
Verification gaps cause more denials than coding errors. Here are 3 ways to close them [...]
From Medical Biller to Imposter Provider: Federal Indictment Exposes Insider Healthcare Fraud
The healthcare system depends on trust—trust that professionals are who they say they are, that patient [...]
LCDs for Certain Skin Substitutes Withdrawn
Effective immediately, CMS’ A/B Medicare Administrative Contractors (MACs) are withdrawing the Local Coverage Determinations (LCDs) for Skin [...]