A PRIVATE-PUBLIC PARTNERSHIP AGAINST HEALTH CARE FRAUD
NHCAA is seeking health care anti-fraud professionals to share best practices, case studies, emerging schemes, investigative skills, clinical knowledge, proven data mining techniques, and investigative solutions at the 2023 programs listed below.
Both programs will be held virtually:
The Annual Training Conference Call for Presentations will open in the first quarter of 2023.
Enhancing Your Skills: Managing & Navigating Complex Investigations
Submission Deadline: January 27Program Dates: April 4 – 6
SUBMIT SKILLS HERE
This program is designed to enhance the skills of middle managers and investigators on the rise. Content focuses on the skills necessary for complex investigations. Speakers present on a skill or utilize a case example to highlight case management best practices for complex cases.
The goals of this program are to provide participants the opportunity to:
In your submission description, please detail the case management skills needed to investigate your complex scheme. Sessions should emphasize ways to enhance and refine skills, ideally with examples of improved investigative outcomes, lessons learned, and habits investigators can adopt immediately.
For skill-based sessions not reliant upon a scheme, unless the skill is unique, no foundation building sessions (i.e., Level I) will be accepted for presentation.
Schemes for Health Care Fraud Investigators & Analysts
Submission Deadline: January 27Program Dates: May 2 – May 12
SUBMIT SCHEMES HERE
This annual training offers investigators and analysts insights on detecting a variety of schemes through case studies, coding, analytics, red flags, and walkthroughs of medical procedures or schemes.
Submissions should provide:
Presentation ideas the E&T Committee would like to see include:
Schemes pertaining to commercial health insurance, supplemental insurance, and government programs are welcome. Submission areas include:
Case Studies & Investigative Strategies
Case study submissions should clearly outline how the case was identified, the role of data in the case, identify the parts of the scheme and corresponding steps of the investigation from beginning to end, explore collaborations and partnerships with other organizations/agencies, and, if applicable, explain relevant steps to preventing future fraud in this area.
Clinical, Coding, & Chart Review
Submissions in this category should advance an investigator or analyst’s understanding of health care fraud through clinical and/or coding knowledge. Speakers might review a procedure, discuss coding discrepancies, or show how a chart review can be completed. Ideal presenters will hold medical credentials or coding credentials (CPC, CPMA, CPC-H, etc.), as NHCAA would like to provide credit through AAPC for this program.
Submissions should include a description of methods used to identify/confirm the scheme, how data was used in the investigation, what codes were identified, and what can be replicated in other investigations.
Please review the information below before submitting a presentation idea.
Below is what NHCAA expects from speakers at our programs and what speakers can expect from the Association.
NHCAA offers membership categories for health insurers, governmental entities, and other companies and organizations that support the NHCAA Mission, as well as individuals, who want to join us in the fight against health care fraud.
Platinum & Premier Supporting Members
National Health Care Anti-Fraud Association Headquarters
1220 L Street, NW, Suite 815 | Washington, DC 20005 | Phone: 202.659.5955 | Fax: 202.785.6764