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FWA: Easing the Search for the Needle in the Haystack-a Review of Spotting Data’s Red Flags

Event Date: 10/17/2019

Event Overview

Thursday, October 17, 2019
1:00 PM CT – 2:00 PM CT (60 minutes)
Hosted by: Cotiviti

This event is hosted on our ReadyTalk platform

 

Data analysis is the key to any fraud, waste and abuse investigation. As technology advances, so too extends the creativity of unscrupulous providers, suppliers and fraudsters willing to exploit and misuse healthcare payer systems to gain improper payments. This session explores key data analysis techniques, including looking at the same data from different angles, to identify improper payments. The session will cover:

  • The red flags of data analysis
  • Various healthcare fraud, waste or abuse schemes and how to identify them through data analysis
  • The answers to key questions that plague their investigative colleagues


Audience

Leaders and managers in SIUs and fraud, waste and abuse roles or departments, data and analytics, and legal professionals. Also those in regulatory, government programs and financial management will benefit from this session.


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Documents
10/17/2019

Presentation: FWA - Easing the Search for the Needle in the Haystack-a Review of Spotting Data's Red Flags
Fraud, waste and abuse experts from Cotiviti help member health plans understand how to spot the red flags in data by employing key data analysis techniques, including looking at the same data from different angles, to identify improper payments.

10/17/2019

Recording: FWA - Easing the Search for the Needle in the Haystack-a Review of Spotting Data’s Red Flags
Fraud, waste and abuse experts from Cotiviti help member health plans understand how to spot the red flags in data by employing key data analysis techniques, including looking at the same data from different angles, to identify improper payments.

Attendees

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

  • Trisha Adams
  • ALLIANCE MEMBER
  • Director, Member Services at Physicians Health Plan
  • Dana Anaya
  • ALLIANCE MEMBER
  • Provider Enablement Consultant at Sentara Health Plans (Optima)
  • Kieley Arakelian
  • ALLIANCE MEMBER
  • Director - Quality Management at Physicians Health Plan
  • Tamara Avery
  • ALLIANCE MEMBER
  • Supervisor Medical Review at CommunityCare
  • Aleem Baig
  • ALLIANCE MEMBER
  • Sr. Director, MIS Core Systems at MetroPlusHealth
  • Michael Baumann
  • ALLIANCE MEMBER
  • Director of Compliance at Baylor Scott & White Health Plan
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Mike Dooley
  • ALLIANCE MEMBER
  • Director of Provider Contracting & Engagement at Avera Health Plans
  • Doris Ewing
  • ALLIANCE MEMBER
  • Coding Analyst at Health Alliance Medical Plans
  • Kelly Faust
  • ALLIANCE MEMBER
  • Pharmacist at Geisinger Health Plan
  • Mary Glasgow
  • ALLIANCE MEMBER
  • Senior Corporate Compliance Auditor at Physicians Health Plan
  • Holli Hansen
  • ALLIANCE MEMBER
  • Contracting Analyst at Avera Health Plans
  • Steve Hearon
  • ALLIANCE MEMBER
  • Medical Department Manager at Cox HealthPlans
  • Jill Henrich
  • ALLIANCE MEMBER
  • Investigator at Geisinger Health Plan
  • Shannon Kast
  • ALLIANCE MEMBER
  • PIU Analyst at Prominence Health Plan
  • Evelyn Kim
  • ALLIANCE MEMBER
  • SIU Manager at Community First Health Plans
  • Gretchen Lagassee
  • ALLIANCE MEMBER
  • Manager, Claims Operations at Community Health Options
  • Flora Lewis
  • ALLIANCE MEMBER
  • Sr. Investigative Analyst at MediGold
  • Jesse Liddell
  • ALLIANCE MEMBER
  • Government Programs Manager at SelectHealth
  • Angie Lovell
  • ALLIANCE MEMBER
  • Director of Operations at Prominence Health Plan
  • Cindy Macdonald
  • ALLIANCE MEMBER
  • Audit and Recovery Specialist at Community Health Options
  • Max Mikulec
  • ALLIANCE MEMBER
  • Operational Analyst Actuarial at Physicians Health Plan
  • 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
  • Charles Palermo
  • ALLIANCE MEMBER
  • Vice President, Claim Services 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
  • Angie Pino
  • ALLIANCE MEMBER
  • Director of Claims Integrity at Community Health Plan of Washington
  • Amanda Potter
  • ALLIANCE MEMBER
  • Manager Data Analytics at Physicians Health Plan
  • Julie Powell
  • ALLIANCE MEMBER
  • Investigator at Sentara Health Plans (Optima)
  • Teresa Powers
  • ALLIANCE MEMBER
  • SIU Analyst - Special Investigations Coordinator at Samaritan Health Plans
  • Rachel Reimann
  • ALLIANCE MEMBER
  • AVP Regulatory Compliance at SelectHealth
  • 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
  • Jeanne Skinner
  • ALLIANCE MEMBER
  • Manager, Appeals & Grievance at Network Health
  • Nakia Smith
  • ALLIANCE MEMBER
  • Chief Compliance & Ethics Officer at Parkland Community Health Plan
  • Arya Steinhauer
  • ALLIANCE MEMBER
  • Director of Internal Audit at Quartz Health Solutions
  • Mike Takach
  • ALLIANCE MEMBER
  • Pharmacy Director at Community Health Options
  • Jill Thomas
  • ALLIANCE MEMBER
  • Clincal Auditor at Geisinger Health Plan
  • Lynn Williams
  • ALLIANCE MEMBER
  • Director, Medical Management at AvMed
  • Tanya Williams
  • ALLIANCE MEMBER
  • Coding Consultant at Health Alliance Medical Plans
  • Erin Rutzler
  • SPEAKER
  • Director of FWA Solutions at Cotiviti, Inc.
Speakers