Fraud, waste, and abuse (FWA) schemes are constantly evolving—and many of the costliest patterns are designed to slip past standard claims editing tools. With growing complexity and provider sophistication, SIUs need more than rules-based detection to stay ahead.
Join Erin Rutzler, Cotiviti’s vice president of FWA, and Heather Rickards, senior investigator, for a deep dive into the most pressing FWA trends—and how to proactively find what more traditional methods can miss. By sharing data analysis and a real-world case study, this session will spotlight patterns that reveal wasteful and abusive billing.
In this session, you’ll learn:
- Which FWA schemes are most likely to evade standard claims editing
- How to uncover behavioral patterns using both prepay and postpay review
- Best practices to prevent abuse and support proactive, data-driven SIU decisions
Don't miss these key strategies to identify patterns of provider behaviors, and insights to strengthen your SIU’s impact without increasing burden or bandwidth.
The National Health Care Anti-Fraud Association (NHCAA) is extending one (1) Continuing Professional Education credit towards the AHFI® designation to attendees of the live webinar that complete the NHCAA attestation online.
