Provider Education

Whether your organization is a payer or provider of medical care, we are here to help educate your physicians, coders, billers and staff on the appropriate medical guidelines as it pertains to their specialty and their governing Federal, State, and Health Plan rules. We have one on one sessions and group meetings with healthcare providers to help them with their practice and support them in their endeavor to reach necessary benchmarks and excel in providing the best care they can. Our Investigation and Audit teams are available to assist payer Special Investigation Units with understanding the details, rational, and evidence associated with the cases we review.

As a healthcare audit and retrospective review organization, we understand the complexity and pressure placed upon physicians and care providers. Providing medical services while maintaining the business operations of a practice can be overwhelming for doctors and billing staff. This is why we offer payers a way to help inform and guide physicians to improve their processes in a proactive way.

Core Healthcare Training Areas

We hold information and educational sessions in the following formats:

• Phone Conferences with the Provider: We are available for one-on-one phone conferences with providers to show them the acceptable ways to adjust their practice to meet medical guidelines.

• Live Group Seminars: Healthcare Fraud Investigations may host a live seminar for our payers and their providers to help them meet standards set by the State, CMS, or their Health Plans.

We at Healthcare Fraud Investigations believe there needs to be ongoing support for physicians who are under an increasing amount of pressure with regard to reporting, record keeping, and managing the business of their practices. This is why we provide clear and understandable training sessions for physicians which payers have elected to receive advanced training and educational support.