Top FWA Schemes Your Payment Integrity Program is Missing And How to Improve Detection
Sponsored by: Cotiviti (registration to this event is strictly limited by the sponsor)
Perpetrators of fraud, waste, and abuse (FWA) continue to evolve their schemes. Traditional claims editing methods are no longer meeting the challenges and complexities of detecting the most costly and pervasive issues.
To minimize losses and protect your health plan, it’s critical to implement advanced technologies and deploy interventions at multiple points throughout the claim lifecycle. In this session, we’ll explore the top emerging FWA trends that often go undetected by standard editing methods. Using real-world examples, we’ll demonstrate how both pre and post-payment strategies can uncover hidden risks — and how to use them in tandem for maximum effectiveness.
In this session, you’ll learn:
- The top FWA schemes that traditional claims editing may overlook.
- How to track provider billing behaviors that may vary across post and prepayment interventions.
- Best practices for deterring undesirable provider patterns.
Faculty
Erin Rutzler, VP Fraud Waste & Abuse
Heather Rickards, Senior Investigator, Fraud Waste & Abuse
Please note: This event is sponsored by Cotiviti, an NHCAA Platinum Supporting Member. Registration is limited and determined by the sponsor, and NHCAA cannot circumvent or alter the sponsor’s registration policies. Registration from personal email addresses and some organizations are not permitted. Please accept our apologies if you are unable to register for this particular event, however, NHCAA does offer other educational programs. Please click here to view upcoming educational opportunities.
