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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

  • Dana Anaya
  • ALLIANCE MEMBER
  • Manger/Nurse Practicioner at Sentara Health Plans (Optima)
  • Karen Andersen
  • ALLIANCE MEMBER
  • RN - Clinical Coding Auditor at SelectHealth
  • Kieley Arakelian
  • ALLIANCE MEMBER
  • Director - Quality Management at Physicians Health Plan
  • Tamara Avery
  • ALLIANCE MEMBER
  • Medical Review Supervisor at CommunityCare
  • Aleem Baig
  • ALLIANCE MEMBER
  • Sr. Director, MIS Core Systems at MetroPlus Health Plan
  • Michael Baumann
  • ALLIANCE MEMBER
  • Manager, SIU at Scott & White Health Plan
  • Pat Bremer
  • ALLIANCE MEMBER
  • Supervisor, Special Investigation Unit at Paramount Health Care
  • Rick Burguieres
  • ALLIANCE MEMBER
  • Senior Compliance Manager, Delegation Oversight at HealthTeam Advantage
  • Emily Corley
  • ALLIANCE MEMBER
  • QI Program Specialist at CommunityCare
  • Mike Dooley
  • ALLIANCE MEMBER
  • Director of Provider Contracting & Engagement at Avera Health Plans (DAKOTACARE)
  • Doris Ewing
  • ALLIANCE MEMBER
  • Coding Analyst at Health Alliance Medical Plans
  • Mary Glasgow
  • ALLIANCE MEMBER
  • Medical Compliance Auditor at Physicians Health Plan
  • Kristin Griego
  • ALLIANCE MEMBER
  • SIU Investigator at Prominence Health Plan
  • Andres Guerrero
  • ALLIANCE MEMBER
  • SIU Investigator at Scott & White Health Plan
  • Holli Hansen
  • ALLIANCE MEMBER
  • Contracting Specialist at Avera Health Plans (DAKOTACARE)
  • Jill Henrich
  • ALLIANCE MEMBER
  • Investigator at Geisinger Health Plan
  • Shannon Kast
  • ALLIANCE MEMBER
  • SIU Analyst at Prominence Health Plan
  • Evelyn Kim
  • ALLIANCE MEMBER
  • SIU Manager at Community First Health Plans
  • Renee Kimm
  • ALLIANCE MEMBER
  • Compliance at Central Health Plan of California
  • Trisha Kopulos
  • ALLIANCE MEMBER
  • Senior Corporate Compliance Analyst at Physicians Health Plan
  • Gretchen Lagassee
  • ALLIANCE MEMBER
  • Assistant Manager, Quality, Audit, and Recovery at Community Health Options
  • Flora Lewis
  • ALLIANCE MEMBER
  • Sr. Investigative Analyst at Mount Carmel Health Plan (MediGold)
  • Jesse Liddell
  • ALLIANCE MEMBER
  • Government Programs Manager at SelectHealth
  • Angie Lovell
  • ALLIANCE MEMBER
  • Operations Manager at Prominence Health Plan
  • Cindy Macdonald
  • ALLIANCE MEMBER
  • Audit and Recovery Specialist at Community Health Options
  • Max Mikulec
  • ALLIANCE MEMBER
  • Operational Analyst at Physicians Health Plan
  • Tammy Miller
  • ALLIANCE MEMBER
  • Business Analyst at Scott & White Health Plan
  • Jaquelynn Mokry
  • ALLIANCE MEMBER
  • Business Analyst at Scott & White Health Plan
  • Debra Nuckols
  • ALLIANCE MEMBER
  • Medicare Program Director at Western Health Advantage
  • Pauline Pahulu
  • ALLIANCE MEMBER
  • Compliance Manager at Care N' Care Insurance Company, Inc.
  • Carol Pawlosky
  • ALLIANCE MEMBER
  • RN, BSN, SIU Program Manager at Mount Carmel Health Plan (MediGold)
  • Leslie Pels-Beck
  • ALLIANCE MEMBER
  • Chief Operations Officer at Sharp Health Plan
  • Tenille Perring
  • ALLIANCE MEMBER
  • Coding Compliance Auditor at Health Alliance Medical Plans
  • Joyce Petermann
  • ALLIANCE MEMBER
  • Coding validator/risk adjustment specialist at Avera Health Plans (DAKOTACARE)
  • KiErrin Phillips
  • ALLIANCE MEMBER
  • Quality Health Integration Clinical Supervisor at Network Health
  • Angie Pino
  • ALLIANCE MEMBER
  • Manager of Claims Investigation, Recovery and Coding 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
  • Special Investigations Coordinator at Samaritan Health Plans
  • Rachel Reimann
  • ALLIANCE MEMBER
  • Regulatory Compliance Administrator and Regional Compliance Officer at SelectHealth
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Director, Claims and BPO Operations at SummaCare
  • Sarah Schultz
  • ALLIANCE MEMBER
  • Internal Auditor at CommunityCare
  • Kelly Skifton
  • ALLIANCE MEMBER
  • Assistant Vice President, Compliance & Government Regulatory Operations at Quartz Health Solutions
  • Jeanne Skinner
  • ALLIANCE MEMBER
  • Manager, Payment Integrity & Recovery at Network Health
  • Nakia Smith
  • ALLIANCE MEMBER
  • Director of Gov't Programs & Compliance at Care N' Care Insurance Company, Inc.
  • 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
  • Dang Tran
  • ALLIANCE MEMBER
  • Clinical Pharmacy Coordinator at Chinese Community Health Plan
  • Tyler Tyburski
  • ALLIANCE MEMBER
  • Senior Business Analyst at Community Health Options
  • Neill Vaughan
  • ALLIANCE MEMBER
  • Special Investigations at CHRISTUS Health Plan
  • Lynn Williams
  • ALLIANCE MEMBER
  • Director, Medical Management at AvMed
  • Tanya Williams
  • ALLIANCE MEMBER
  • Coding Consultant at Health Alliance Medical Plans
  • Kristen Wilson
  • ALLIANCE MEMBER
  • Operational Analyst at Physicians Health Plan
  • Kelly Yelenic
  • ALLIANCE MEMBER
  • Pharmacist at Geisinger Health Plan
  • Leslie Groves
  • SPEAKER
  • Director, Product Marketing at Cotiviti (formerly Verscend Technologies)
  • Erin Rutzler
  • SPEAKER
  • Director of FWA Solutions at Cotiviti (formerly Verscend Technologies)
  • Devon Snyder
  • SPEAKER
  • Investigations Supervisor at Cotiviti (formerly Verscend Technologies)
  • Mark Starinsky
  • SPEAKER
  • Director of FWA Products at Cotiviti (formerly Verscend Technologies)
Speakers