When validating investigations of provider fraud, waste, or abuse (FWA), payers typically take one or more of the following actions: education, prepay review, settlement and recovery, or pursuit of prosecution. But positive behavior change is hard to measure and pinpointing which postpay investigation led to prepay review can prove difficult.
Deploying prepay and postpay investigations simultaneously offers many benefits for health plan special investigative units (SIUs), including:
- Providing more information the health plan can use to educate providers or deliver a correction plan
- Reducing provider abrasion by consolidating medical record requests
- Improving risk mitigation through an approach that is both proactive and reactive
- Increasing the probability of provider behavioral change
- Strengthening evidence for law enforcement referrals when appropriate
I invite you to join me and Cotiviti’s senior FWA investigators, Whitney Organ and Brittny Eberhart, for an on-demand webinar as we discuss how to approach investigations, interventions, and behavior tracking across prepay and postpay FWA programs.
During our webinar, you’ll learn about:
- Sequencing investigative activities in the right order and with the right intervention mechanisms to increase positive behavior changes
- Case studies showcasing how Cotiviti’s FWA team is achieving positive results with an end-to-end FWA approach
- Best practices for yielding change in behavior and more FWA prevention in 2023
Don’t miss this opportunity to improve your strategies in 2023 for long-term success.