2015 Annual Training Conference & Anti-Fraud Expo

Julie Heit
Dental Hygienist, Manager - Ancillary Utilisation Review
Bupa Australia


Julie Heit has over 20 years experience in dentistry as a Dental Therapist, Dental Surgery Assistant and Dental Practice Manager and over 19 years experience as a clinical, risk management, and a compliance professional in private health insurance in Australia. Julie has developed proactive and retrospective claims leakage and fraud prevention strategies for dental and ancillary modalities. She has developed integrated system supported business and clinical rules for the Fund’s claiming systems. She has also developed a range of analytical, desk and on site audit methodologies, and ensured adequate controls in product design, provider registration criteria and network contracts. She has overseen the recent introduction of predictive analytics and data mining techniques. This has built on previous work in benchmarking, and provider, member and Fund staff profiling, and complemented earlier work on the design of bespoke analytical software by Fund staff.Her knowledge and experience has been pivotal in developing strategies in the identification and management of inappropriate and incorrect servicing practices and aberrant behaviours by ancillary health service providers. These strategies and actions have resulted in savings of in excess of $46 million, comprising recoveries and changes in claiming behaviours of providers over the last 10 years.

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