Advize Welcomes Laurie McMillan as Director of Healthcare Payment Integrity Policy
Advize, an industry leading analytics, audit and advisory provider helping organizations fight healthcare fraud, waste and abuse today announced the onboarding of Medicare expert Laurie McMillan to their litigation support practice.
PLANO, Texas, Feb. 2, 2022 /PRNewswire-PRWeb/ -- McMillan is a healthcare industry veteran with nearly 40 years of clinical, audit, law enforcement and expert witness experience. Currently, McMillan holds an RN license from the Texas Board of Nurses, a Certified Professional Coder – Payer (CPC-P) certification and a Certified Fraud Examiner designation from the American Association of Certified Fraud Examiners.
Her health care compliance experience began with reviewing medical documentation for Hierarchal Condition Categories (HCC's), utilized in Medicare Part C reimbursement. She then spent time working for a Medicare Administrative Contractor (MAC), both in Medical Review and later as a Team Leader in the Appeals Department. She gathered extensive experience working with Medicare payment policies while making claim payment decisions utilizing Medicare Part A, Home Health and Hospice rules and regulations. She went on to work for a Program Integrity Contractor (ZPIC/UPIC), initially working in the medical review department reviewing documentation regarding payment policy (Medicare Part A, Medicare Part B, Home Health and Hospice), and highlighting indicators of fraud, waste, and abuse.
McMillan spent several years as a law enforcement liaison, assisting the OIG, FBI, and DOJ with coordinating and facilitating medical reviews performed by the UPIC for both Civil and Criminal investigations. During her time as a law enforcement liaison with the UPIC she worked with Medicare claims data, assisting in proactive data analysis and providing input into determining claims data pertinent in supporting/negating allegations of fraud, waste, and abuse. She has conducted various trainings for nurse reviewers, UPIC investigators, the OIG, FBI, and the DOJ. She has testified in multiple cases involving the criminal prosecution of health care fraud, waste, abuse in the Medicare Trust Fund.
"We are thrilled to welcome Laurie to the team. Her unmatched industry experience will be an invaluable asset to our team and our clients. Bringing Laurie on board is the latest in a series of strategic expansions across our service lines to continue identifying fraudulent activity and reducing the rising cost of healthcare," said Jeanmarie Loria, CEO of Advize.
McMillan will be serving as a subject matter expert in litigation for Advize, working closely with clients and the Department of Justice as an expert in federal prosecutions. McMillan's expertise is highly sought after, with several government bodies requesting her partnership and expert witness capabilities.
ABOUT ADVIZE
Advize provides a full suite of services to healthcare organizations of all sizes, from government entities to commercial payers, group practices, hospitals, and clinics. Focused on reducing the cost of healthcare and improving the quality of delivery, Advize takes a unique client-centered approach to delivering industry best results. Advize's staff augmentation strategy engages leading subject matter experts (SMEs) to provide results at more competitive prices than other practices in the industry. Call upon Advize's strong legal experience for expert guidance on healthcare cases and transitional work.
Media Contact
Jeanmarie Loria, Advize, 1 8135692352, [email protected]
SOURCE Advize
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