Log in/Register

Return to search

FWA Detection and Prevention: Two Health Plan Case Studies

Event Date: 3/4/2021

Event Overview

Thursday, 3/4/2021
11:00 AM CT – 12:00 PM CT (60 minutes)
Hosted by: Healthcare Fraud Shield

This webinar will review the effectiveness of fraud detection and prevention program and the payor/vendor partnership. IU Health Plans and SelectHealth will present compelling case studies on how their FWA process and detection activities have been effective largely due to their partnership with strong Healthcare Fraud Shield. Attendees will learn about enhancements to existing software solutions aided in the detection of new schemes including COVID-19 FWA. In addition, health plans will discuss various case examples and their respective approaches to combating FWA in 2020.

 

Audience

Stakeholders responsible for fraud, waste, and abuse detection and prevention, and those involved in SIUs at their plan. Those responsible for compliance and legal aspects of FWA along with team members in government programs are also invited to join the call.

 

Ask your peers a question or share a resource anytime through the Alliance discussion forum

You can visit the discussion forum and post a question anytime. It's only available to Alliance members, so your question is private and secure. When submitting a question, you can select which topics your question is related to. Individuals who have indicated in their Alliance profile they are interested in those topics and are opted in to discussion forum emails will receive your question. You can also add an attachment to your question or reply, making this tool another great resource for sharing best practices with your peers.

Start a discussion

 


Other recommended events

 

Register now for these upcoming events

View the presentation materials from these recent events

 

 

Documents
3/11/2021

Recording: FWA Detection and Prevention: Two Health Plan Case Studies
This webinar reviews effectiveness of fraud detection and prevention program and the payor/vendor partnership. IU Health Plans and SelectHealth present compelling case studies on how their FWA process and detection activities have been effective largely due to their partnership with strong Healthcare Fraud Shield.

3/4/2021

Presentation: FWA Detection and Prevention: Two Health Plan Case Studies
This webinar reviews effectiveness of fraud detection and prevention program and the payor/vendor partnership. IU Health Plans and SelectHealth present compelling case studies on how their FWA process and detection activities have been effective largely due to their partnership with strong Healthcare Fraud Shield.

3/4/2021

Template: Vendor evaluation workbook
IU Health Plans shared their vendor evaluation workbook template during the FWA Detection and Prevention: Two Health Plan Case Studies webinar on March 4, 2021.

3/4/2021

Template: Reference checks
IU Health Plans shared their reference checks template during the FWA Detection and Prevention: Two Health Plan Case Studies webinar on March 4, 2021.

Attendees

Below is a list of all delegates registered to date for this event

  • Faith Achenbach
  • ALLIANCE MEMBER
  • Physician Compliance Auditor II at Baylor Scott & White Health
  • Trisha Adams
  • ALLIANCE MEMBER
  • Director, Member Services at Physicians Health Plan
  • Robyn Anderson
  • ALLIANCE MEMBER
  • Delegation Oversight Auditor at Health Alliance Plan (HAP)
  • Ann Bain
  • ALLIANCE MEMBER
  • Compliance Coordinator & Privacy Officer at Avera Health Plans
  • Michael Baumann
  • ALLIANCE MEMBER
  • Director of Compliance at Baylor Scott & White Health Plan
  • Trent Began
  • ALLIANCE MEMBER
  • AVP Finance at Samaritan Health Plans
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Janet Bylow
  • ALLIANCE MEMBER
  • Senior FWA Investigator at Paramount Health Care
  • Meagan Canney
  • ALLIANCE MEMBER
  • Audit and Recovery Specialist at Community Health Options
  • Wynda Clayton
  • ALLIANCE MEMBER
  • Risk Adjustment Manager at Providence Health Plan
  • Karla Colasacco
  • ALLIANCE MEMBER
  • CPhT at FirstCarolinaCare Insurance Company
  • Kathy Coslett
  • ALLIANCE MEMBER
  • SIU Manager at Geisinger Health Plan
  • Lisa Denney
  • ALLIANCE MEMBER
  • FWA Supervisor at Johns Hopkins Health Plans
  • Kathleen Durham
  • ALLIANCE MEMBER
  • Senior SIU Investigator at Paramount Health Care
  • Raymond Evans
  • ALLIANCE MEMBER
  • Investigator at Health Alliance Plan (HAP)
  • Mary Glasgow
  • ALLIANCE MEMBER
  • Senior Corporate Compliance Auditor at Physicians Health Plan
  • Holli Hansen
  • ALLIANCE MEMBER
  • Contracting Analyst at Avera Health Plans
  • Jill Henrich
  • ALLIANCE MEMBER
  • Investigator at Geisinger Health Plan
  • Elizabeth Heying
  • ALLIANCE MEMBER
  • Counsel & Compliance Manager at Medical Associates Health Plans
  • Karen Jensen
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment and SIU at Quartz Health Solutions
  • Tina Korty
  • ALLIANCE MEMBER
  • Vice President, Health Plans Legal, Compliance & Regulatory at IU Health Plans
  • Elizabeth Lewallen
  • ALLIANCE MEMBER
  • Medicare Compliance Analyst at Western Health Advantage
  • Jesse Liddell
  • ALLIANCE MEMBER
  • Government Programs Manager at SelectHealth
  • Cindy Macdonald
  • ALLIANCE MEMBER
  • Audit and Recovery Specialist at Community Health Options
  • Leila Makki
  • ALLIANCE MEMBER
  • College Intern at Health Alliance Plan (HAP)
  • Tammy Miller
  • ALLIANCE MEMBER
  • Business Analyst at Baylor Scott & White Health Plan
  • Mai-Phuong Nguyen
  • ALLIANCE MEMBER
  • FWA Program Manager at Santa Clara Family Health Plan
  • Carol Pawlosky
  • ALLIANCE MEMBER
  • RN, BSN, SIU Program Manager at MediGold
  • Leslie Pels-Beck
  • ALLIANCE MEMBER
  • Chief Operations Officer at Sharp Health Plan
  • Wade Penner
  • ALLIANCE MEMBER
  • Manager Revenue-Risk at Samaritan Health Plans
  • Julie Powell
  • ALLIANCE MEMBER
  • Investigator at Sentara Health Plans (Optima)
  • Teresa Powers
  • ALLIANCE MEMBER
  • SIU Analyst - Special Investigations Coordinator at Samaritan Health Plans
  • Dana Renicker
  • ALLIANCE MEMBER
  • Medicare Education Specialist at SummaCare
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Emily Schultz
  • ALLIANCE MEMBER
  • Medical Auditor at Physicians Health Plan
  • Stefanie Shelton
  • ALLIANCE MEMBER
  • Sr. Claims and Reimbursement Specialist at Community Health Plan of Washington
  • Jeanne Skinner
  • ALLIANCE MEMBER
  • Manager, Appeals & Grievance at Network Health
  • Bonnie Swaney
  • ALLIANCE MEMBER
  • Sr. Project Manager at Samaritan Health Plans
  • Jill Thomas
  • ALLIANCE MEMBER
  • Clincal Auditor at Geisinger Health Plan
  • Cheryl Zingaro
  • ALLIANCE MEMBER
  • Manager, AS&I and Subrogation at AvMed
Speakers