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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
  • 4/18/2019
  • 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

  • Annie Shieh
  • ALLIANCE GUEST
  • Senior Compliance Counsel at Central Health Plan of California
  • Olamide Akanbi
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medicare Compliance Coordinator at Paramount Health Care
  • Karen Andersen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN - Clinical Coding Auditor at SelectHealth
  • Jessica Arrambidez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager Strategic Projects and Business Process Improvement at CHRISTUS Health Plan
  • John Baker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Regulatory Operations & Program Integrity Department at Presbyterian Health Plan
  • Michael Baumann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • JorDwn Bowers
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Compliance Investigator at Health Alliance Plan (HAP)
  • Bill Bradish
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Investigator at Presbyterian Health Plan
  • Pat Bremer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Data Specialist at Paramount Health Care
  • Rick Burguieres
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Compliance Manager, Delegation Oversight at HealthTeam Advantage
  • Janet Bylow
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior FWA Analyst at Paramount Health Care
  • Dotha Canning
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Health Information at Samaritan Health Plans
  • Amy Cornett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Compliance Auditor at Scott & White Health Plan
  • Bill Crunk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Special Investigation Coordinator at Samaritan Health Plans
  • Linda Cummings
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Clinical Quality Examiner at MetroPlus Health Plan
  • Nicole Davanzo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN, Compliance Manager - Fraud, Waste and Abuse at Health First Health Plans
  • Philip David
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Investigator at AvMed
  • Christine Day
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Analyst at Health Alliance Plan (HAP)
  • Crystal Djordjevic
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Consultant at Health Alliance Medical Plans
  • Michelle Faniola
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Integrity Investigator III at Presbyterian Health Plan
  • Juan Gonzalez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU - Auditor at Network Health
  • Kristin Griego
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Investigator at Prominence Health Plan
  • Tanner Gutelius
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Analyst at Geisinger Health Plan
  • Kim Hackenberg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Data Analyst at Geisinger Health Plan
  • Brooke Haycraft
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Analyst at Quartz Health Solutions
  • Loriann Heinssen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of HFHP Compliance at Health First Health Plans
  • Freda Hogan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Network Development at Health Alliance Plan (HAP)
  • Barbara Hoyt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Contract Specialist at Paramount Health Care
  • Grace Johnson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Team Coordinator, Program Integrity/SIU at Sentara Health Plans (Optima)
  • Shannon Kast
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Analyst at Prominence Health Plan
  • Erin Kavanagh
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coordinator at Samaritan Health Plans
  • Angie Lovell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Operations Manager at Prominence Health Plan
  • Deborah Marine
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Officer at SummaCare
  • Greta Matus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • FWA Special Investigator at Health Alliance Medical Plans
  • Lisa McIntire
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Contractor at PreferredOne
  • Mary Ann McLean
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Compliance at Scott & White Health Plan
  • Lisa Meinburg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Investigator at Health Alliance Plan (HAP)
  • Briana Merrill-Belval
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Director at Western Health Advantage
  • Tamara Migut
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Managed Care Pharmacist at Health Alliance Medical Plans
  • Tammy Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • Terrica Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Chief Compliance & Risk Officer at Health Alliance Medical Plans
  • Sara Neese
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • COO at Health Plan Alliance
  • Lisa Odom
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CFO at Cox HealthPlans
  • Shani Pacheco
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Analyst at SummaCare
  • Charles Palermo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director at Health Alliance Plan (HAP)
  • Carol Pawlosky
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN, BSN, SIU Program Manager at Mount Carmel Health Plan (MediGold)
  • Dipali Portwood
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Compliance Auditor at Scott & White Health Plan
  • Teresa Powers
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Special Investigations Coordinator at Samaritan Health Plans
  • Cindy Ramos
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Health Care Investigator at MetroPlus Health Plan
  • Jean Rao
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Manager at Chinese Community Health Plan
  • Elizabeth Rich
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • FWA Program Manager at Indiana University Health Plans
  • Katherine Ross
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Fraud, Waste and Abuse Analyst at Paramount Health Care
  • Marc Rueckert
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Audit, Investigations and Recovery Services Director at SelectHealth
  • Melissa Rusk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Claims and BPO Operations at SummaCare
  • David Sand
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Medical Officer at Care N' Care Insurance Company, Inc.
  • Paul Schlegelmann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Project Manager at Samaritan Health Plans
  • Christine Senty
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President, General Counsel & Secretary at Quartz Health Solutions
  • Kelly Skifton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Assistant Vice President, Compliance & Government Regulatory Operations at Quartz Health Solutions
  • Nakia Smith
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Gov't Programs & Compliance at Care N' Care Insurance Company, Inc.
  • Nichole Stebane
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Auditor at Network Health
  • Jesse Warner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Internal Audit at Network Health
  • Andrea Yap
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Enterprise Risk Management Coordinator & SIU at Paramount Health Care
  • Christopher Zapart
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Investigator at Geisinger Health Plan
  • Karen Weintraub
  • SPEAKER
  • Executive Vice President at Healthcare Fraud Shield
Speakers