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Unified Cost Containment Approach and
Next-Level Outcomes Using AI

  • June 09, 2021
  • 1:00 PM – 2:00 PM ET
  • Online
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Health care leaders today are under increased pressure to bring down health care costs and move toward greater transparency and collaboration across all departments and throughout the entire payment spectrum. Many health insurance providers, however, are faced with relying on siloed, disparate solutions and data that create further challenges.

These pressures are driving health insurance providers and state agencies to seek a unified approach to fraud detection and create greater efficiencies and effectiveness across cost containment operations. To address this current and pressing need, more and more the value of artificial intelligence (AI) is evaluated for its ability to impact fraud, waste, abuse and payment integrity (PI) programs and outcomes.

Join us as we discuss practical approaches to creating an AI-driven unified approach to cost containment for improved access, transparency, and outcomes across the cost containment spectrum.

Attendees will:

  • Hear effective strategies for total claims, provider and data analysis for faster, earlier and more comprehensive detection of exposure
  • Understand and see a use case for how AI is helping save significant dollars and facilitate cost avoidance throughout the payment spectrum – from fraud, waste and abuse, through pre-pay, post-pay, contract reviews, and provider education and compliance
  • Learn best practices to creating transparencies across all teams involved in FWA and PI programs

Speakers


Musheer Ahmed, PhD
CEO & Founder
Codoxo

Dr. Ahmed is the CEO and Founder of Codoxo. He founded Codoxo (formerly named FraudScope) to help make our healthcare system more affordable and effective. Codoxo’s Forensic AI Platform uses patented technology to identify problems and suspicious behavior earlier than traditional techniques, which helps ensure our scarce healthcare dollars go to real patient care.

Dr. Ahmed developed this technology as a part of his Ph.D. dissertation at the Georgia Institute of Technology. A report by the JASON advisory group, the prestigious scientific advisory panel to the US government, reinforced that his doctoral research tackled some of the biggest challenges within the emerging health data infrastructure in the United States. Several media outlets have interviewed Dr. Ahmed for his work in reducing healthcare fraud, waste, and abuse.


Rena Bielinski, PharmD, AHFI
Vice President of Customer Success
Codoxo

Dr. Bielinski is the Vice President of Customer Success at Codoxo. Prior to Codoxo, she spent 15 years at SCIO Health Analytics, an EXL Company, where she was the Chief Pharmacy Officer, with responsibility for building several clinical cost containment programs. She also developed the Retail Pharmacy FWA program which included pharmacy fraud investigations and compliance audits. She also served as a Vice President of Strategic Accounts at EXL, managing multiple payer and PBM clients.

Prior to SCIO, she spent many years as the Chief Operating Officer for a regional home infusion, home health, and DME company.

She has a Doctor of Pharmacy degree from the University of Illinois College of Pharmacy in Chicago (UIC), and she is also an Accredited Healthcare Fraud Investigator (AHFI).