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FRAUD, WASTE, AND ABUSE

Webinar: Sequencing investigative activities for greater provider impact

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 

Watch now

Don’t miss this opportunity to improve your strategies in 2023 for long-term success.

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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