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SIU Data Analytics Tool Success Story

Event Date: 4/18/2019

Event Overview

Thursday, April 18, 2019
1:00 PM CT – 2:00 PM CT (60 minutes)
Hosted by: Prominence Health Plan with Healthcare Fraud Shield

This event is hosted on our ReadyTalk platform

As a health plan working on developing an SIU, Prominence Health Plan began a search for a data analytics tool that was not only user friendly, intuitive and adaptable, but one that provided a central location for case documentation, identifying potentially fraudulent billing and ad-hoc querying capabilities.  They evaluated multiple options, and ultimately elected to work with FWAShield and have been pleased with the support provided by them! 

During this webinar you will hear from Kristin Griego at Prominence as she shares an overview of steps they took to evaluate and select Healthcare Fraud Shield as their vendor and share some of the key areas they were looking for in their vendor search, and overview of the implementation process, and lessons learned.  Karen Weintraub from Healthcare Fraud Shield will also provide a brief demo of the tool and answer any questions members may have. 


Members will learn:

•         The history of both Prominence and Healthcare Fraud Shield
•         Success stories
•         Advice when seeking a vendor
•         What the solution looks like through a brief demo
•         What the future holds

Audience

Those with an interest in cost containment, payment integrity, FWA detection and prevention and roles in FWA/SIU departments, claims department and executive staff.


 

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Documents
4/29/2019

Recording: SIU Data Analytics Tool Success Story
Kristin Griego at Prominence shares an overview of steps they took to evaluate and select Healthcare Fraud Shield as their vendor and share some of the key areas they were looking for in their vendor search and lessons learned. Karen Weintraub from Healthcare Fraud Shield demonstrates the tool and answers members' questions.

4/18/2019

Presentation: SIU Data Analytics Tool Success Story
Kristin Griego at Prominence shares an overview of steps they took to evaluate and select Healthcare Fraud Shield as their vendor and share some of the key areas they were looking for in their vendor search and lessons learned. Karen Weintraub from Healthcare Fraud Shield demonstrates the tool and answers members' questions.

Attendees

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

  • Michael Baumann
  • ALLIANCE MEMBER
  • Director of Compliance at Baylor Scott & White Health Plan
  • Bill Bradish
  • ALLIANCE MEMBER
  • Manager-SIU at Presbyterian Health Plan
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Janet Bylow
  • ALLIANCE MEMBER
  • Senior FWA Investigator at Paramount Health Care
  • Amy Cornett
  • ALLIANCE MEMBER
  • VP, Compliance at Baylor Scott & White Health Plan
  • Linda Cummings
  • ALLIANCE MEMBER
  • Lead Clinical Quality Examiner at MetroPlusHealth
  • Nicole Davanzo
  • ALLIANCE MEMBER
  • Director, Payment Integrity at Health First Health Plans
  • Christine Day
  • ALLIANCE MEMBER
  • Provider Data Quality Analyst at Health Alliance Plan (HAP)
  • Crystal Djordjevic
  • ALLIANCE MEMBER
  • Risk Adjustment Education Specialist at Health Alliance Medical Plans
  • Michelle Faniola
  • ALLIANCE MEMBER
  • Program Integrity Investigator III at Presbyterian Health Plan
  • Kim Hackenberg
  • ALLIANCE MEMBER
  • Data Analyst Supervisor at Geisinger Health Plan
  • Lori Heinssen
  • ALLIANCE MEMBER
  • Director Appeals and Grievances at Health First Health Plans
  • Shannon Kast
  • ALLIANCE MEMBER
  • PIU Analyst at Prominence Health Plan
  • Erin Kavanagh
  • ALLIANCE MEMBER
  • Risk Adjustment Analyst at Samaritan Health Plans
  • Angie Lovell
  • ALLIANCE MEMBER
  • Director of Operations at Prominence Health Plan
  • Tamara Migut
  • ALLIANCE MEMBER
  • Director of Quality Management at Health Alliance Medical Plans
  • Tammy Miller
  • ALLIANCE MEMBER
  • Business Analyst at Baylor Scott & White Health Plan
  • Sara Neese
  • ALLIANCE MEMBER
  • Former COO for Health Plan Alliance at
  • Charles Palermo
  • ALLIANCE MEMBER
  • Vice President, Claim Services at Health Alliance Plan (HAP)
  • Carol Pawlosky
  • ALLIANCE MEMBER
  • RN, BSN, SIU Program Manager at MediGold
  • Teresa Powers
  • ALLIANCE MEMBER
  • SIU Analyst - Special Investigations Coordinator at Samaritan Health Plans
  • Cindy Ramos
  • ALLIANCE MEMBER
  • Health Care Investigator at MetroPlusHealth
  • Marc Rueckert
  • ALLIANCE MEMBER
  • Program Integrity Director at SelectHealth
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Christine Senty
  • ALLIANCE MEMBER
  • interim President and Chief Executive Officer at Quartz Health Solutions
  • Annie Shieh
  • ALLIANCE MEMBER
  • Sr. Director of Compliance, CA Compliance Officer at Central Health Plan of California
  • Kelly Skifton
  • ALLIANCE MEMBER
  • Assistant Vice President, Compliance & Government Regulatory Operations and Privacy at Quartz Health Solutions
  • Nakia Smith
  • ALLIANCE MEMBER
  • Chief Compliance & Ethics Officer at Parkland Community Health Plan
  • Jesse Warner
  • ALLIANCE MEMBER
  • Director of Internal Audit at Network Health
  • Andrea Yap
  • ALLIANCE MEMBER
  • Manager of Financial Controls, Model Audit Rule, ORSA at MediGold
Speakers