Unnecessary claim losses from fraud, abuse and errors are costing your organization tens of millions of dollars. Today, leading healthcare payers are utilizing advanced analytic technologies to accurately pinpoint fraudulent and abusive claims activity – before and after payment - to dramatically reduce losses and improve investigator efficiency. Learn how your organization can increase savings through the prevention of claims-level fraud, identification of large provider cases, and the detection of editing gaps or other policy vulnerabilities.

• Leverage advanced technologies to maximize prepayment and postpayment detection
• Implement fraud fighting systems within your organization
• Reap the rewards: Results from successful fraud fighting initiatives

Andrea Allmon
Sr. Director of Healthcare Product Management
FAIR ISAAC CORPORATION

This workshop is cancelled.  If you are registered for this workshop, please contact IIR Customer Service at 888-670-8200 to select an alternative.

Retail-based health clinics have attracted good attention from the public, the medical establishment, investors and retailers. These clinics have grown rapidly, and consumers across all economic groups are increasing their use of clinics and reporting high levels of satisfaction. Learn what services are provided today, and projected for the future

• Discover what role technology plays in this industry
• Discover how to get your community on-board with your clinic
• Gain insight into guidelines and discuss legislative hot topics
• Find out how public policy may shape this industry
• The Future of Accessible Healthcare
• Are Clinics the Answer to Quality Affordable Healthcare?
• How are traditional providers responding?
• Explore how Health Plans are Turning to Clinics to Reduce Costs
• Uncover how Health Systems are Getting Involved
• Grasp how Partnerships are Integral to Making this ModelWork

This workshop describes a new, innovative program implemented by the State of Indiana, and backed by a visionary Governor, that uses cash incentives, predictive modeling, and individual health coaching - coupled with effective communications - to drive down healthcare costs Instead of applying a “broad-based” solution and looking only at past healthcare usage (traditional disease management), the State finds and targets those that will become the sickest employees –10-15% of the costliest employees – with individualized help. This proactive, targeted approach allows the State to have a quick impact on lowering claims.

• Demonstrate the importance of moving beyond traditional disease management to find those employees that have a combination of issues and factors that will lead to an acute (costly) crisis in the near-term
• Identify how to implement a successful incentive program and why this is critical to the success of a new health management program
• Understand why one-on-one, individualized coaching and intervention via the phone is critical to stemming high claims and improving individual health and productivity