Though steps are being taken to fight healthcare fraud, there is much more that can be done. We are seeing new schemes and repeated fraud practices happening within provider networks throughout the country as we work with CMS and health plans to combat these violations. Through our network of over 550 licensed field and desktop investigators we are able to identify these situations before they become a major risk to the payors.

Ray Evans and Chandra Kuti will discuss the ever-evolving healthcare system involving state and federal regulations constantly changing along with the significant increase in utilization in the post-pandemic environment. They will review how this increase in claims volumes will effect the vulnerability for health plans and ways to identify any FWA issues that may be flying under the radar.

For over 20 years, CoventBridge Group has served as a Fraud, Waste and Abuse program integrity contractor for The Center for Medicare and Medicaid Services investigating Medical Provider FWA in Medicare, Medicaid, and commercial lines of business.

Armed with proven analytics utilizing over two decades of FWA expertise, enhanced with our proprietary algorithms and machine learning capabilities, our mission is to assist health plans in protecting their organizations from FWA through an experienced, flexible, and sensitive approach to minimizing provider abrasion, while still achieving organizational objectives.

Join our discussion on what the future holds for FWA and tactics to leverage the BIG Three --- identify – investigate – recover.