Monthly Archives: October 2013

Recent report finds that the government significantly underestimates the benefits of its health care fraud recoveries

The Taxpayers Against Fraud (“TAF”) Education Fund recently reported that the Department of Justice’s (“DOJ’s”) False Claims Act data dramatically underestimates the amount of money actually recovered to the government. In fact, according to TAF, the federal government’s return on …

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Insurance Authorization (Milliman) Challenges

Having trouble with Pre authorizations for surgery! Healthcare reform has dramatically changed how spinal surgical procedures are authorized by payors. Payors have adopted diagnostic and treatment algorithm such as the Milliman Care Guidelines with requisite diagnostic documentary criteria and non-operative …

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