Enhanced identification of Emerging Fraud Schemes by Embedding AI and rapidly deploying targeted rules - including COVID-19 schemes

Event Date: 6/11/2020

Event Overview

Thursday, June 11, 2020
11:00 AM CT – 12:00 PM CT (60 minutes)
Vendor Spotlight Host: Healthcare Fraud Shield

This vendor spotlight is hosted on our BigMarker platform. You must use the Google Chrome or Firefox browsers when participating in the webinar.

Healthcare Fraud Shield will discuss what they are seeing in fraud activity today with particular focus on COVID-19 related schemes and behaviors that are just now beginning to appear in claims data. They will also describe how they are using AI to gain new insights into as yet ‘undefined’ fraud schemes and then leverage these new insights to improve our rules-based alerts. Find out what to look out for and how you can best separate fraudulent behavior from new treatment protocols before they are defined within the standardized claim code system.

During this presentation:

Learn what your SIU can do to prepare for COVID-19 related schemes
Find out what you can do to catch new, undefined schemes sooner
Learn how to leverage AI in your analytics for maximum impact
Hear actual case studies about how AI made an impact on FWA investigations
Learn the pros and cons of both rule-based and AI approaches
Learn what to look for in your claims data that may indicate COVID-19 related fraud

Notice to Participants:

Please note that this webinar is a Vendor Spotlight and will be a capabilities-focused presentation. While this vendor is not under contract with the Health Plan Alliance, we believe this webinar will provide you the opportunity to learn more about this vendor and the programs and services it provides. Offering this webinar does not imply that the Health Plan Alliance endorses this vendor. The webinar is merely for informational purposes only. Should you wish to share feedback and/or have questions about this vendor, please contact Jaime González, the Alliance’s Chief Business Development Officer, at jaime.gonzalez@healthplanalliance.org or 972-830-6355.

Documents

6/11/2020

Presentation: Enhanced identification of Emerging Fraud Schemes by Embedding AI and rapidly deploying targeted rules - including COVID-19 schemes
Healthcare Fraud Shield discusses what they are seeing in fraud activity today with particular focus on COVID-19 related schemes and behaviors that are just now beginning to appear in claims data. They also describe how they are using AI to gain new insights into as yet "undefined" fraud schemes and then leverage these new insights to improve our rules-based alerts.

6/11/2020

Recording: Enhanced identification of Emerging Fraud Schemes by Embedding AI and rapidly deploying targeted rules - including COVID-19 schemes
During this video presentation with Healthcare Fraud Shield you will learn about fraud activity today with particular focus on COVID-19 related schemes and behaviors that are just now beginning to appear in claims data.