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Thursday, May 13, 2010
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7:00 am -
8:00 am
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8:00 am -
11:30 am
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- What is compliance?
- What type of compliance program do you have in place?
- If you are not compliant, do you know what you need to do to become compliant?
- Do you know enforcement laws and how they can impact you?
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| Workshop Thought Leader: TBD |
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11:30 am -
1:00 pm
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1:00 pm -
1:15 pm
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1:15 pm -
1:45 pm
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- Health Care Fraud Prevention and Enforcement Action Team (HEAT)
and Strike Force teams
- Senior Medicare Patrol: how senior adults are taking control and educating their
peers to comprehend Medicare statements and report fraudulent activities
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Department of Health and Human Services Representative: TBD (invited)
U.S. Department of Justice Representative: TBD (invited) |
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1:45 pm -
2:30 pm
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- Define fraud, waste and abuse and how each have different priorities
- Hear the various schemes and scants that are happening in Medicare, Medicaid
and Commercial Coverage
- Gain a perspective on the overall cost impact of fraudulent, abusive and wasteful
activities in the system
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2:30 pm -
3:15 pm
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- Hear the elements, checks and balances that Kaiser Foundation Health Plan has
developed to enhance accurate billing to the government
- Review their check list and explore the number of audits completed to ensure
appropriate outcomes
- Understand how the organization's compliance program has been leveraged to
specifics employed to revenue cycle and billing
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3:15 pm -
3:45 pm
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3:45 pm -
4:30 pm
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- Hear different methods on how to identify fraud, waste and abuse
- Discover the schemes Independence Blue Cross has experienced and how they
have handled the investigation process
- Successful cases on how information was used to identify providers and billing
entities involved in fraud
- Recognize enablers of fraud, waste and abuse
- Recommendations and strategies on how to address fraud
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4:30 pm -
5:15 pm
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- Identify your fraud and abuse targets
- Learn how to be proactive to avoid the pay and chase scenario
- Recognize how to speak and understand coding language to increase prevention
- Make the sentinel effect work for you by auditing members and providers, which
prevents other providers from committing fraud and abuse against your plan
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5:15 pm -
6:00 pm
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- Investigative strategies
- How a case is investigated from start to finish
- How interviews are conducted and what key information must be extracted
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6:00 pm -
6:15 pm
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6:15 pm -
7:15 pm
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