Fraud, waste, and abuse (FWA) risks are becoming more complex as health plans work to reduce improper spend, strengthen oversight, and move beyond traditional pay-and-chase models. For many organizations, sustainable prevention requires more than isolated investigations or retrospective recoveries. It depends on a coordinated strategy that brings payment integrity and special investigative unit (SIU) teams together around shared goals and action.
Health plans are increasingly focused on building payment integrity programs that can identify suspicious patterns sooner, reduce administrative burden, and protect plan resources while supporting provider relationships and member outcomes. That means using both prepay and postpay insights to create feedback loops that help teams learn from emerging issues to apply those lessons earlier in the claim lifecycle. With personalized data, teams can make more informed decisions about when to review, educate, deny, or refer.
I invite you to join me and industry peers Rob Bledsoe, SIU Manager at BCBS South Carolina, and Heather Walters, Director of COB Programs and Payment Integrity at Health Alliance Plan by Henry Ford Health, for our webinar as we discuss how health plans can future-proof FWA prevention with a partnership-driven approach.
Register for our webinar on September 8 at 1 pm ET as we explore how plans can:
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Strengthen collaboration between payment integrity and SIU teams
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Use post-to-pre feedback loops to identify risk earlier
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Integrate FWA prevention into a complete payment integrity program with aligned goals
If you can’t attend the live webinar, be sure to register so we can send you the on-demand recording. Don’t miss this opportunity to learn how a partnership-driven approach can help health plans stay ahead of emerging FWA risks and build a more effective, future-ready payment integrity program.
