A PRIVATE-PUBLIC PARTNERSHIP AGAINST HEALTH CARE FRAUD
Based on a review of member investigations and feedback from our committees and leaders, NHCAA has selected remote patient monitoring (intraoperative neuromonitoring), temporal mandibular disorders, and durable medical equipment fraud as the topics for the 5th annual Top Schemes webinar. Participants will hear strategies to detect, investigate, and prevent fraud in all three areas. Detailed descriptions are below.
DME FraudDurable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) are types of equipment which can withstand repeated use. As one of the top reported provider types for fraudulent billing, this session will focus on the shifting schemes in this space and red flags to identify these issues in your own claims systems.
Jason BockFraud InvestigatorBlue Cross Blue Shield of Michigan
Temporal Mandibular DisordersThe temporomandibular joint (TMJ) is the connecting hinge mechanism between the base of the skull (temporal bone) and the lower jaw (mandible). Temporomandibular joint dysfunction (TMD or TMJD) is the abnormal functioning of the temporomandibular joint. It also refers to symptoms arising in other areas secondary to the dysfunction. Review fraudulent billing for Temporomandibular Joint Disorder (TMJ or TMD) therapy service, including the billing and coding of services associated with TMD and fraud schemes.
Hana Hasson, DDS, MSPA Dental DirectorAvesis, LLC
Ruthann Pardo, BSN, RN, CFESr. Financial InvestigatorMedical Mutual of Ohio
Intraoperative NeuromonitoringIntraoperative neuromonitoring (IONM) is the continuous surveillance of a patient’s nervous system (i.e., brain, spinal cord and nerves), which can be at risk during surgery. While this monitoring can offer extra protections for patient safety, it is very costly and can be abused in terms of overuse and inadequate disclosure to patients. Review the parties involved with IONM and the reasons that drive this towards fraud, waste and abuse.
Ashely Stein, CPA, CFESenior InvestigatorPoint32Health
Dues paying Member Organizations can designate up to two tuition-free registrations per webinar. Government Liaisons and Platinum and Premier Supporting Members can designate one tuition-free registration per webinar. All Individual Members, Supporting Members, and non-members (including local, state, and federal public agencies who are not Liaisons) need to submit a registration form and applicable payment.
For both Tuition-Free and paid registrations additional webinar lines are $100.
Registration closes at 3:00 pm ET the day before the webinar.
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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.
All webinars are approved by: NHCAA for 1.5 CPEs and NASBA for 1.5 CPEs
Participants earn 1.5 Continuing Professional Education (CPE) hours applicable to the training requirements for the Accredited Health Care Fraud Investigator (AHFI®) designation.
The NHCAA Institute is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org.
NASBA Field of Study: Specialized Knowledge & Applications
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National Health Care Anti-Fraud Association Headquarters
1220 L Street, NW, Suite 815 | Washington, DC 20005 | Phone: 202.659.5955 | Fax: 202.785.6764