Building the Right Fraud, Waste, and Abuse Prevention Model: Perspective, Promises, and Performance

December 4, 2013
12:00 pm - 1:30 pm ET

Presented by LexisNexis 

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Whether an act is technically labeled “health insurance fraud” or “health insurance abuse”, the impact can be equally profound, with patients put at financial and physical risk. According to the federal website, PaymentAccuracy, the government made nearly $65 billion in improper health care-related payments, and government agencies have been hard at work trying to put a stop to it—but with limited results. Even though $1.7 billion was spent to combat fraud, waste and abuse in 2010, less than 10 percent of fraudulent dollars were recovered. The problem is real and so must be the approach taken in attempt to solve it.

For decades other industries have leveraged data, technology and analytics to find new ways of identifying and intercepting fraud, waste and abuse. Now these same capabilities are available to health care and promise to deliver significant improvements in this area with the right execution. Understanding how to couple these capabilities with the current DNA of an organizations anti-fraud units is key to realizing success. This webinar will explore various stages and stages and levels of sophistication across payer anti-fraud efforts and discuss key components of a mature fraud model including the use of data, technology and analytics.

Explore different perspectives in the market related to fraud detection and prevention Understand the promises different technologies and strategies offer Hear successes realized by payers that have leveraged advanced analytics.


  • Mark Isbitts, LexisNexis, Director of Market Planning


The content presented in this webinar is solely attributable to the speaker and does not represent an endorsement by America's Health Insurance Plans (AHIP) of the accuracy of the information presented in the audio conference or any opinion expressed by the speaker.