Need Assistance? Call Us Today! 318-213-0904
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Life Changing Solutions, LLC takes the detection, investigation, and prosecution of fraud and abuse very seriously, and has a fraud, waste and abuse Corporate Compliance Program that complies with Louisiana and federal laws. With oversight from the Compliance Officer, directors and managers will establish and maintain methods for detecting and preventing fraud, waste and abuse, including but not limited to:

Information system claims reviews such as appropriateness of services and level(s) of care, reasonable charges, and potential excessive over-utilization.

A claims quality assurance program that monitors the accuracy of adjudicated claims.

Ongoing monitoring process that identifies employees, contractors, vendors and providers that are debarred or excluded from participating in federal programs.

Prior authorization policies and procedures (member eligibility verification, medical necessity, appropriateness of service requested, covered service verification, appropriate referral).

Utilization management practices.

Quality improvement practices- Quality Assurance program designed to prevent fraud, waste and abuse.

Employee/Staff and member handbooks language regarding the reporting of potential fraud, waste and abuse.

Staff training on the False Claims Act regarding potential fraud, waste and abuse occurrences, detection and reporting. Such training occurs at least annually and is a part of the orientation for new staff members. False Claims Act training will include:

  • Detailed information on the False Claims Act and the administrative solutions for false claims and statements
  • Louisiana laws pertaining to civil or criminal False Claims Act penalties
  • Whistleblower rights
  • The organization’s requirements for preventing, detecting and reporting fraud, waste and abuse.

Monitoring of staff member’s and client’s complaints and grievances.

Some of the most common FWA

  • Billing for services or procedures that have not been performed.
  • Submitting false information about the services performed or the charges for services performed.
  • Inserted a diagnosis code that has not been obtained from a physician or other authorized individual.
  • Misrepresenting the services performed (for example, upcoding to increase reimbursement)
  • Violation of another law. For example, a claim was submitted appropriately but the service was the result of an illegal relationship between a physician and the hospital (physician received kick-backs for referrals)
  • Submitting claims for services ordered by a provider that has been excluded from participating in Medicare, Medicaid and other federally funded healthcare programs and federally funded contracts.
  • Knowingly submitting a claim for goods, services or supplies which are medically unnecessary or of a substandard quality or quantity.

To report FWA please contact us at our hotline: 1-855-886-2465.

Get in touch Our Locations

Mailing Address: P.O. Box 1792, Shreveport, LA 71166

Life Changing Solutions - Shreveport

6015 Hearne Avenue

Shreveport, LA 71108

Phone: 318-213-0904 Fax: 318-213-0905

Life Changing Solutions - Alexandria

2002 Gus Kaplan Drive

Alexandria, LA 71301

Phone: 318-542-4642 Fax: 318-787-6440

Life Changing Solutions - Lafayette

315 S College Road, Ste. 100

Lafayette, LA 70503

Phone: 337-205-6073 Fax: 337-264-9282