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.

Support Services

Advize

Jeanmarie Loria

William J. Quandt

Msn Nana Grant Rn

Michelle Dolinski

Bsn Lisa Moore Rn, Cpc

Ethan Montgomery

Dena B.

Van Prewitt

Stefanie Lawrence

Robin L. Kessinger

Alexis Flickner

Sandra Pletz

Janice Brown

Brittany McClafferty

Crc Susan Pakulski Ccs-P

Sheri Vickery

Cpc David Bolden Cpco

Matt Kochanski

Julie Janeway

Jeanmarie Loria Mba, Pmp, Cpc

The Leadership Team at Advize is responsible for setting the strategic direction of the company and ensuring alignment with its mission to enhance provider relationships through data-driven insights. Comprised of the CEO and President, this team guides operational excellence in auditing and reporting services, drives innovation in fraud detection methodologies, and upholds the highest standards of integrity and compliance. Their leadership fosters a culture of collaboration and accountability, promoting best practices that ultimately improve healthcare outcomes for payers and providers alike.

Leadership Team

Clinical Audit and Assessment Team

Healthcare Compliance Team

Leadership Team

About

Team members

Other teams at Advize

Clinical Audit and Assessment Team

Healthcare Compliance Team