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SIU Investigation Flow and Best Practices

Event Date: 7/18/2019

Event Overview

Thursday, July 18, 2019
1:00 PM CT – 2:00 PM CT (60 minutes)
Hosted by: Mount Carmel Health Plan

This event is hosted on our ReadyTalk platform

The key to any successful investigation is organization and communication.  In this informative webinar for those involved with SIUs and managing fraud, waste and abuse, you will hear from Flora Lewis, Senior Investigative Analyst at Mount Carmel Health Plan (Medigold) as she walks you through their successful investigation flow process.  Members will share and learn about SIU investigation process best practices and lessons learned.


Members will learn about:

  • Tracking and organizing a typical SIU investigation
  • How a custom Access data gets the job done
  • Key inputs and information necessary for any investigation
  • Helpful websites that improve investigation flow

Audience

Those with an interest in SIU process development, management, tools and resources to support investigations.


 

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 you question is private and secure. When submitting a question, you can select which topics your question is related to, such as "risk adjustment" or "coding". 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.


 

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Documents
7/18/2019

Presentation: SIU Investigation Flow and Best Practices
Flora Lewis, Senior Investigative Analyst at Mount Carmel Health Plan (Medigold) walks through their successful investigation flow process. Members share and learn about SIU investigation process best practices and lessons learned.

7/18/2019

Recording: SIU Investigation Flow and Best Practices
Flora Lewis, Senior Investigative Analyst at Mount Carmel Health Plan (Medigold) walks through their successful investigation flow process. Members share and learn about SIU investigation process best practices and lessons learned.

Attendees

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

  • Carrie Abenante
  • ALLIANCE MEMBER
  • Manager, Special Investigations Unit at Sentara Health Plans (Optima)
  • Michael Baumann
  • ALLIANCE MEMBER
  • Director of Compliance at Baylor Scott & White Health Plan
  • Belinda Bean
  • ALLIANCE MEMBER
  • Compliance specialist at MediGold
  • Stephanie Belue
  • ALLIANCE MEMBER
  • Director of Quality Assurance & Privacy Officer at Alliant Health Plans
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Karen Brunton
  • ALLIANCE MEMBER
  • Project Manager at Medical Associates Health Plans
  • Janet Bylow
  • ALLIANCE MEMBER
  • Senior FWA Investigator at Paramount Health Care
  • Dan Carabine
  • ALLIANCE MEMBER
  • Compliance and FWA Manager at Health New England
  • Amy Cornett
  • ALLIANCE MEMBER
  • VP, Compliance at Baylor Scott & White Health Plan
  • Kathy Coslett
  • ALLIANCE MEMBER
  • SIU Manager at Geisinger Health Plan
  • Corinna Daunt
  • ALLIANCE MEMBER
  • Product Consultant at Health Alliance Plan (HAP)
  • Lisa Denney
  • ALLIANCE MEMBER
  • FWA Supervisor at Johns Hopkins Health Plans
  • Lisa Garrett
  • ALLIANCE MEMBER
  • Risk Adjustment Manager at Sentara Health Plans (Optima)
  • 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 Hoffmann
  • ALLIANCE MEMBER
  • Director of Operations at Medical Associates Health Plans
  • Kim Houk
  • ALLIANCE MEMBER
  • Senior Pharmacy Data Analyst at MediGold
  • Shu Jing
  • ALLIANCE MEMBER
  • Clinical Pharmacy Manager at MetroPlusHealth
  • Shannon Kast
  • ALLIANCE MEMBER
  • PIU Analyst at Prominence Health Plan
  • Molly Knapsack
  • ALLIANCE MEMBER
  • Senior Actuarial Analyst at Geisinger Health Plan
  • Tina Korty
  • ALLIANCE MEMBER
  • Vice President, Health Plans Legal, Compliance & Regulatory at IU Health Plans
  • Joan Lambright
  • ALLIANCE MEMBER
  • Compliance & Audit Specialist at MediGold
  • Susan Leitzell
  • ALLIANCE MEMBER
  • Lead Fraud Investigator at Geisinger Health Plan
  • Flora Lewis
  • ALLIANCE MEMBER
  • Sr. Investigative Analyst at MediGold
  • Jesse Liddell
  • ALLIANCE MEMBER
  • Government Programs Manager at SelectHealth
  • John Lim
  • ALLIANCE MEMBER
  • Head of Member Experience Operations at MetroPlusHealth
  • Abigail Luebbert
  • ALLIANCE MEMBER
  • Sr Compliance Analyst at Western Health Advantage
  • Julie Meersman
  • ALLIANCE MEMBER
  • Compliance Consultant at SelectHealth
  • Tammy Miller
  • ALLIANCE MEMBER
  • Business Analyst at Baylor Scott & White Health Plan
  • Jaquelynn Mokry
  • ALLIANCE MEMBER
  • Physician Compliance Auditor at Baylor Scott & White Health Plan
  • Wendy Owen
  • ALLIANCE MEMBER
  • Sr. Fraud & Abuse Investigator at Sentara Health Plans (Optima)
  • Bhamini Patel
  • ALLIANCE MEMBER
  • Project Manager at Health Alliance Plan (HAP)
  • Carol Pawlosky
  • ALLIANCE MEMBER
  • RN, BSN, SIU Program Manager at MediGold
  • Leslie Pels-Beck
  • ALLIANCE MEMBER
  • Chief Operations Officer at Sharp Health Plan
  • Jana Pennington
  • ALLIANCE MEMBER
  • Risk Adjustment Analytics Manager-Coding at Saint Luke's Health System
  • Julie Powell
  • ALLIANCE MEMBER
  • Investigator at Sentara Health Plans (Optima)
  • Teresa Powers
  • ALLIANCE MEMBER
  • SIU Analyst - Special Investigations Coordinator at Samaritan Health Plans
  • Daniel Quan
  • ALLIANCE MEMBER
  • Manager, Medicare Compliance at Santa Clara Family Health Plan
  • Cindy Ramos
  • ALLIANCE MEMBER
  • Health Care Investigator at MetroPlusHealth
  • Rachel Reimann
  • ALLIANCE MEMBER
  • AVP Regulatory Compliance at SelectHealth
  • Dana Renicker
  • ALLIANCE MEMBER
  • Medicare Education Specialist at SummaCare
  • Janet Robbins
  • ALLIANCE MEMBER
  • Director of Financial and Risk Management at Sentara Health Plans (Optima)
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Kelly Skifton
  • ALLIANCE MEMBER
  • Assistant Vice President, Compliance & Government Regulatory Operations and Privacy at Quartz Health Solutions
Speakers