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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

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