Let it snow ☃️ It’s not just the weather forecast it’s budget season, audit planning season, and goal-setting season. The most successful SIU/PI programs don’t just react they forecast: • Investigations likely to surge in Q1 • Coding and billing risks tied to new regs • Resource needs (staffing, technology, outsourcing) Now’s the time to model scenarios and set measurable 2026 KPIs. 💬 What’s one big metric you’ll be watching next year? Share the top metric you’re watching in 2026. We’ll highlight the trends across the industry in our upcoming insights post. Let us know in the comments 👇 #HealthcareForecast #SIUPlanning #PaymentIntegrity #HealthcareAnalytics #AdvizeHealth Advize
Advize
Hospitals and Health Care
Orlando, Florida 72,250 followers
Healthcare & IT Audit & Advisory, Program Integrity, Compliance and Consulting for Payers, Providers, Legal & Government
About us
After nearly two decades of auditing large data sets and performing extrapolation for increased ROI for payers, Advize has shifted focus to building relationships with providers based on data and best practices. Our team has expanded our model of coding and billing audits focused on waste and abuse to examine fraud through Big-4 Data Analytics and OIG best practices. Audit and Support Services – Record Retrieval, Storage, Purge – Onsite record retrieval – Send request letters and other communications with providers – Secure file upload (SFU) – Records are stored securely and discarded in accordance with HIPAA recommendations and requirements – Minimum necessary PHI accessed – Record files are securely returned with audit result delivery – Corporate Integrity Agreements – Statistically valid sampling – Medical necessity and proper coding/documentation review – Audit Management and Quality Assurance Support – QA Review – Reporting and Results Delivery – Overpayment Recovery and Overpayment Support – Legal Support – Case building, expert witness, audit, reporting and testimony Review and Reporting – Reviews performed by highly experienced and credentialed auditors – Audit personnel work with a variety of healthcare personnel and patients. They should always conduct themselves in an acceptable, professional manner and adhere to ethical standards, confidentiality requirements, and objectivity. Auditors trained to completely document their findings and problems. – Perform verification of charges – What citations are important, and what policies are important? – Citation guidebook creation – Review of claims – Generation of preliminary audit results – Results delivery and collaboration with client – Report generation – Final Audit Results: – Contain final audit reporting, this reporting will have included the overpayment amount. – Review the next steps for the provider who was audited.
- Website
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https://advizehealth.com
External link for Advize
- Industry
- Hospitals and Health Care
- Company size
- 51-200 employees
- Headquarters
- Orlando, Florida
- Type
- Privately Held
- Founded
- 2003
- Specialties
- Litigation Support, Medical Necessity, Record Collection, Claims Review, Healthcare, Claims, Healthcare Legal Support, Medical Records, Consulting, Expert Witness, HITRUST, FWA, OIG, CMS, UPIC, DRG, HCPCS, Arbitration, Audit, Advisory, Medical Record Audit, SIU, Compliance, Analytics, Federal, Healthcare Consulting, Expert Testimony, Hubzone, Women Owned, Government, and CPC
Locations
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Primary
Get directions
Orlando, Florida, US
Employees at Advize
Updates
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🔪The Old Way of Investigating Is Dead☠️ Episode 5 of Class of ‘09 opens with the FBI talking to a Senator: “We’re rebuilding our entire approach.” That line hit us hard. Because that’s exactly what the best SIUs, PI teams, and compliance departments should be doing right now. We’re still acting like it’s 1999, manually reviewing cases, waiting on medical records, “personally” looking at every email, every claim, every line item. Minute 10 of the episode makes it clear: No one can personally review every email. No one can personally review every claim. And yet, that’s still how many payers run their operations. AI isn’t meant to just tell you where the fraud is, It’s meant to free up your best people to do the work that matters. If we’re still using AI to sort claims like cookies on a baking sheet, we’re wasting it. AI should be helping us find the one chocolate chip cookie in the batch that’s full of razor blades. Stop doing investigations the old way. Stop wasting technology. Rebuild your approach. #innovation #investigation #SIU #technology Advize
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Eric wasn't sure. Jeanmarie insisted. 🎉 We're having a special OIG ROUNDTABLE Party...and you are invited! 🎤 Hosted by our one and only Jeanmarie Loria, this event will be packed with good vibes and even better stories. ✨ Come in your ugliest holiday sweater, sip on your favorite festive drink, and drop your pics in the chat - we’ll be keeping the side convo just as fun as the main event!
🎄OIG Roundtable LIVE: The Holiday Edition🎄
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🎯 What if being an exceptional leader isn’t about extraordinary talent? What if it is simply about mastering the ordinary? The truth: leadership isn’t a spotlight moment. It’s built in the quiet, daily choices that earn trust and respect. Today we are thankful for our exceptional leaders and honor these 5 talents that they share: * Speak with clarity. * Observe before you react. * Affirm with precision. * Reflect openly. * Own your presence. At Advize, we believe leadership isn’t about titles, it’s about how you show up. Turning authority into trust. Presence into influence. Good intentions into action. Because exceptional leadership isn’t magic. It’s intentional ordinary. 💡 #Leadership #EverydayLeadership #AdvizeHealth #TrustAndInfluence #HealthcareIntegrity #thanksgiving #thankful
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Spring gets all the credit for cleaning, but fall is when you get your house in order before the new year. Before 2026 hits, ask: • Are your SIU workflows streamlined or clunky? • Is your triage process catching the right cases? • Are your analytics producing actionable leads or just noise? Advize specializes in fall clean-ups: aligning teams, auditing processes, and clearing backlogs. What would you “sweep out” of your program right now? Let us know in the comments 👇 #ProgramIntegrity #SIU #ProcessImprovement #HealthcareConsulting #AdvizeHealth
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🐾 Blue Pill or Red Pill? 💊 A few weeks ago, we showed you our newest investigator, wearing blue and “sniffing out fraud.” But what happens when you take the red pill? You start to see what others miss. You question the data. You connect the dots no one else does. That’s what Program Integrity is about - choosing to know the truth, even when it’s uncomfortable. At Advize, we’ll always take the red pill. 💊 #AdvizeHealth #FraudWasteAbuse #ProgramIntegrity #HealthcareHeroes #DataDetectives #TheMatrix #SundaySniffTest
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We're #hiring a new Health Fraud Investigator Lead/Supervisor in United States. Apply today or share this post with your network.
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We're #hiring a new Technical Writer in United States. Apply today or share this post with your network.
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A Season of Gratitude - And Growth 💙 Join us in Welcoming Megan McCarthy, AHFI, our new Senior Director!
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Top Podcasts in 2025 now released! Did your favorite make the cut? The Joe Rogan Experience The Daily The Mel Robbins Podcast Crime Junkie Dateline NBC SmartLess Call Her Daddy This American Life Huberman Lab The Ezra Klein Show Apple thank you for your list. Please join us for our weekly OIG Roundtable where Matt Kochanski, Eric Rubenstein, MSCJ, CFE, and Wade McFaul get together with their other #HHS #OIG friends to give us a view of healthcare that we typically don't see. Read more here 👉 https://lnkd.in/gWbSkvj9
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