HEALTHCARE FWA SOLUTIONS

Effective and Experienced investigations to recover revenue, ensure compliance and minimize provider abrasion.

Identify, Prevent, and Fight Healthcare FWA.

CoventBridge Group’s industry leading expertise in revenue recovery and compliance, combined with our deep understanding of the need to maintain and improve provider relationships, enables us to successfully balance these competing priorities while delivering a valuable return to our health plan clients.

For over 20 years, the CoventBridge team has served as an FWA contractor for CMS investigating Medical Provider Fraud, Waste, & Abuse in Medicare, Medicaid, and commercial lines of business.

Strong roster of data analysts for prospective & retrospective reviews, Certified Coder Registered Nurses for clinical review and a national network of licensed investigators, along with in-house legal and clinical resources.

Experienced, flexible, and sensitive approach to preventing provider abrasion, while still achieving client objectives.

Use Cases:

Program Management

Audits & Assessments

Compliance Assessment

Medicare, Medicaid & Commercial FWA

On-site & Desktop Audits

Vendor Management

Document Retrieval & Analysis

Investigative Medical Record Review

Medical Record Retrieval

Medical Record Review & Coding (RN)

Medical & Healthcare Canvassing

Investigative Services

Alive and Well Checks

Clinic Surveillance

Healthcare FWA Investigations

Investigative Reports

Law Enforcement Referrals

Staff Augmentation

Data Analysts

Investigators

Nurse Reviewers

RN Consultants

Services:

Credit Balance Audits

Data Analysis

Desktop Audits

Document Scanning

Facility Inspections

Field Investigations

Healthcare Fraud Investigations

Investigative Medical Review

Law Enforcement Referrals

Medical Record Retrieval & Review

On-site Audits

Payment Recovery

Pharmacy Audits

Pre-payment & Post-Payment Reviews

Provider Education

Site Verifications

Surveillance

Turn-key SIU Programs

MedScout

Our customizable integrated platform consisting of a secure document repository, analytics engine, medical review system & configurable reporting.