2015 Annual Training Conference & Anti-Fraud Expo

Sessions Speakers Exhibitors Show Specials Floor Plan Buzz

Freestanding Emergency Centers (Room Seaport A)

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

Tracks: Fraud Schemes and Investigative Skills

In recent years, hospitals have moved some traditionally hospital-based healthcare services out of the hospitals to external entities. One of these external entities is freestanding emergency centers (FSEC). Similarly with existing urgent care centers and ambulatory surgical centers, detecting and addressing FWA concerns from FSECs may present a new and unique challenge to the SIU. These challenges include identifying differences in traditional ER billing patterns and differences in federal and state regulation and oversight for these facilities. This session explores these challenges and presents suggestions to identify potentially aberrant FSEC billers. Once identified, faculty will demonstrate the application of the appropriate techniques and resources to questionable FSEC to insure an efficient investigation with a positive return on investment.