How to Identify Fraud, Waste and Abuse in Value Based Care
Coding, Documentation, & Technology Risks
The healthcare landscape is shifting from fee-for-service to value-based care, creating new opportunities for fraud, waste, and abuse. Risk adjustment, quality, and clinical documentation programs play critical roles in supporting this evolving model, but they have also become focal points for regulatory scrutiny and legal action.
In this interactive session, participants will examine recent high-profile settlements and legal cases that illustrate key risk areas in value-based care. The speaker will use these examples to highlight red flags, patterns, and vulnerabilities that can occur across organizations.
Real-world medical record examples will be used to enhance practical skills in identifying coding and documentation issues that could lead to improper payments, whether intentional or inadvertent. In addition, participants will explore how technologies, including AI and electronic medical records, can both strengthen and compromise program integrity.
This webinar is designed to provide actionable strategies and data analysis tips that can be applied in a variety of organizational contexts, including those still investigating fraud in a fee-for-service model.
Learning Objectives
By the end of this webinar, participants will be able to:
- Identify key risk areas and common fraud schemes associated with value-based care and risk adjustment programs.
- Understand the requirements for compliant querying and coding for value-based care.
- Analyze medical record documentation and coding examples to detect potential anomalies that may indicate fraud, waste, or abuse.
- Recognize the problematic areas of emerging technology for value-based coding and outpatient clinical documentation integrity programs
Speaker:
Colleen Gianatasio, MHS, CPC, CPCO, CRC, CDEO, CPC-P, CPMA, CPPM, CCS, CCDS-O, CHA, AHFI, CPC-I
Vice President, Compliance, CoventBridge
Registration Information
Employees of NHCAA Member Organizations, Government Liaisons, Supporting Members, and Individual Members can register online for NHCAA webinars. A registration form is not available, you must login as a member to register. If you are having issues logging in or registering, please contact training@nhcaa.org.
Non-members, including local, state, and federal public agencies who are not NHCAA Government Liaisons, do not have access to NHCAA webinars.
REGISTRATION RATES
| August 5 – 31, 2025 | After August 31, 2025 | |
| NHCAA Member Organizations1 | Complimentary | Complimentary |
| NHCAA Government Liaisons2 | Complimentary | $50 |
| Individual Members3 | $50 | $50 |
REGISTRATION POLICIES
Complimentary registration closes on the last day of the month. Paid registration is open for three (3) additional months after the complimentary time-period ends. The registration period for both complimentary and paid registrations will end at 11:59 pm Pacific Time.
Cancellation/Substitution
All cancellations (regardless of date) will be assessed with a $10 administrative fee.
All written notice of cancellations and substitutions should be sent via email to training@nhcaa.org. Cancellations received within 5 days of the date of purchase will result in a refund minus an administrative fee if the training has not occurred. No refunds will be issued if any portion of the webinar has been viewed. Registrations are non-transferrable for webinars.
Concerns
For more information regarding administrative policies such as refunds, cancellations and complaints, please email training@nhcaa.org.
Details & Frequently Asked Questions
Webinar programs are most appropriate for beginning and mid-career analysts, investigators, consultants, and law enforcement agents working in the health care anti-fraud industry.
As a level II, or intermediate program, some investigative / health care / coding expertise is assumed. Training content is focused on the detection and investigative processes, using case examples to highlight strategy and techniques.
There are no pre-requisite requirements to attend webinar programs.
Participants earn 1 Continuing Professional Education (CPE) hours applicable to the training requirements for the Accredited Health Care Fraud Investigator (AHFI®) designation.Webinars are delivered via NHCAA Learn. You will need a good internet connection and an up-to-date version of Chrome, Firefox, Edge, or Safari. Internet Explorer is not recommended and will not render content correctly.
Video content will open in a pop-up window. You may need to disable a pop-up blocker.
Our FAQ website will be available soon. Registration and login questions can go to training@nhcaa.org. Questions about content or NHCAA Learn functionality can be directed to learn@nhcaa.org.
