2015 Annual Training Conference & Anti-Fraud Expo

How A Multi-pronged Approach and Use of Visualization is Most Effective to Reduce False Positives and Maximize FWA Initiatives (Room Gaslamp A-D)

18 Nov 15
11:00 AM - 12:00 PM

Tracks: Anti-Fraud Technology Solution

Speaker(s): Brad Vinson, CPC-P, Supervisor, Investigative Analytics, Change Healthcare; Louise Dobbe, Esq, Director, Investigative Operations and Analytics, Change Healthcare

Learn how a multi-pronged approach is more effective in identifying potential FWA cases. This includes analytics with multi-plan data sets, complex code edits, investigative flags, and human review to uncover high risk claims. Using any single technique is less effective than combining a string of techniques in reducing false positives and maximizing initiatives. Effective identification techniques are the first component. The second is presenting visualizations that illustrate the significance of your findings. Discover how visualizations can impact your findings and the message you deliver. Examples highlight cases where these techniques were used to effectively identify and resolve high risk cases.