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FRAUD, WASTE, AND ABUSE

Focusing on prepay FWA prevention at NHCAA's Annual Training Conference

Fraud, waste, and abuse (FWA) costs the healthcare system billions of dollars annually. Inappropriate or fraudulent claims are often paid due to burdensome caseloads, disparate record systems, incomplete data sets, and mandated processing efficiencies. In fact, postpayment efforts typically result in recovery of 60–70% of verified waste and abuse—and just 5% of fraud. In contrast, when Cotiviti’s Claim Pattern Review solution verifies a claim as being associated with waste, abuse or error, 100% of the incorrect payment can be prevented while still meeting prompt-pay requirements.

Join Cotiviti for the 2022 NHCAA Annual Training Conference and learn what it means to be certain amid unrelenting changes in healthcare.

While you're there, attend our speaking session: Remaining in fraud compliance while preventing more waste and abuse as we're joined by Jennifer Putt, CFE, SIU manager for Highmark Wholecare. Our presenters will use examples of FWA trends to explain how a combination of claims-based and provider-centric reviews, both post-payment and prepayment, can help prevent claim waste and abuse while minding strict fraud compliance guidelines.

Attendees will learn:

  • Data analysis techniques to identify claims and providers flying under the radar that may lead to long-term fraudulent activity
  • Best practices for administering an effective FWA program, inclusive of retrospective and prospective reviews, to manage compliance requirements and optimize savings
  • How Cotiviti’s Payment Accuracy Solutions execute a collaborative approach to claims review, resulting in incremental savings for our clients and catching bad actors before significant losses are incurred.

Learn more

Attend our session, stop by our booth, and see how Cotiviti can help you prevent errors, waste and abuse while identifying fraud sooner, delivering both medical and dental cost savings. We look forward to seeing you there!

WRITTEN BY

Erin Rutzler
As vice president of fraud, waste, and abuse (FWA), Erin is responsible for the oversight and strategic direction of Cotiviti’s FWA solution suite. In her role, Erin has been integral in the development of Cotiviti’s FWA solutions over the past ten years. Serving as the company’s primary subject matter expert in investigations and FWA for compliance, client training, sales, and marketing activities, she regularly represents the company at industry conferences such as the National Health Care Anti-Fraud Association’s (NHCAA) Annual Training Conference (ATC).

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