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FWA: Tracking and Predicting New Schemes for Greater Savings

Event Date: 10/19/2021

Event Overview

Tuesday, 10/19/2021
1:00 PM CT – 2:00 PM CT (60 minutes)
Hosted by: MetroPlusHealth and Cotiviti

With potential new healthcare challenges on the horizon, it’s important to track trends now more than ever. With insights from the COVID-19 pandemic, health plans can be more predictive regarding new potential schemes. Certain services such as telehealth and behavioral health have risen tremendously over the last year. Cotiviti will review recent case studies on these two areas, providing recommendations to shift from retrospective review to predictive analysis for greater health plan savings. Participants will learn approaches to:

 

  • Identify schemes utilizing data-driven insights associated with telehealth and behavior health services
  • Utilize techniques to become more predictive towards emerging schemes
  • Understand best practices for a holistic payment integrity approach to FWA detection and prevention

Audience

Alliance health plan member MetroPlusHealth and Cotiviti team up to bring FWA leaders innovative approaches for predicting fraud schemes and insights that lead to valuable cost savings.




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Attendees

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

  • Deb Abbott
  • ALLIANCE MEMBER
  • Risk Adjustment and Payment Integrity Coordinator at Network Health
  • 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)
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Tammy Chadd
  • ALLIANCE MEMBER
  • Compliance Manager at IU Health Plans
  • 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
  • Raymond Evans
  • ALLIANCE MEMBER
  • Investigator at Health Alliance Plan (HAP)
  • Jeremy Fejfar
  • ALLIANCE MEMBER
  • Pharmacy Director Government Programs at Quartz Health Solutions
  • Mary Glasgow
  • ALLIANCE MEMBER
  • Senior Corporate Compliance Auditor at Physicians Health Plan
  • Miles Glew
  • ALLIANCE MEMBER
  • FWA Program Manager at Community Health Plan of Washington
  • Jill Henrich
  • ALLIANCE MEMBER
  • Investigator at Geisinger Health Plan
  • Sheri Hoffman
  • ALLIANCE MEMBER
  • Fraud, Waste, and Abuse Investigator at Geisinger Health Plan
  • Simone Ingram
  • ALLIANCE MEMBER
  • SIU Investigator at Health Alliance Plan (HAP)
  • Karen Jensen
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment and SIU at Quartz Health Solutions
  • Shannon Kast
  • ALLIANCE MEMBER
  • PIU Analyst at Prominence Health Plan
  • Tina Korty
  • ALLIANCE MEMBER
  • Vice President, Health Plans Legal, Compliance & Regulatory at IU Health Plans
  • Flora Lewis
  • ALLIANCE MEMBER
  • Sr. Investigative Analyst at MediGold
  • Mary McMaster
  • ALLIANCE MEMBER
  • Lead Investigator at CommunityCare
  • 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
  • Peter Peter
  • ALLIANCE MEMBER
  • Director of Pharmacy at Texas Children's Health Plan
  • Teresa Powers
  • ALLIANCE MEMBER
  • SIU Analyst - Special Investigations Coordinator at Samaritan Health Plans
  • Cindy Ramos
  • ALLIANCE MEMBER
  • Health Care Investigator at MetroPlusHealth
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Emily Schultz
  • ALLIANCE MEMBER
  • Medical Auditor at Physicians Health Plan
  • Arya Steinhauer
  • ALLIANCE MEMBER
  • Director of Internal Audit at Quartz Health Solutions
  • Elaine Taylor
  • ALLIANCE MEMBER
  • Compliance Consultant at IU Health Plans
  • Jill Thomas
  • ALLIANCE MEMBER
  • Clincal Auditor at Geisinger Health Plan
  • Sophia Wagener
  • ALLIANCE MEMBER
  • Intern at Central Health Plan of California
  • John Waugh
  • ALLIANCE MEMBER
  • Director - SIU at Johns Hopkins Health Plans
Speakers