[Webinar] The Role of Analytics Technology in Fraud Prevention
NOW AVAILABLE ON-DEMAND | DURATION: 1 hour
-- Cosponsored by FierceHealthPayer:AntiFraud and NHCAA -- Attendees will be eligible to receive 1 CPE at the conclusion of this webinar
As anti-fraud efforts move from detection to prevention, payers, providers and government agencies are increasingly turning to data analytics technology to spot trends, identify outliers and share information that could point to bigger fraud schemes.
Join FierceHealthPayer:AntiFraud and NHCAA for this exclusive webinar, where you’ll learn how Cigna, Humana, the U.S. Department of Defense and FloridaBlue are using sophisticated data analytics to make earlier and more confident determinations of fraud. Attendees will also learn about proven data techniques that have exposed medically implausible scenarios and prevented fraudulent activity. Attendees of this webinar will be eligible to receive one Continuing Professional Education credit at the conclusion of the one-hour event.
Thomas Hixson — Director, Special Investigations, Cigna
Tom Hixson has over 20 years of experience in the insurance industry with the last 10+ years dedicated to the Special Investigations Unit. He has conducted internal investigations relating to Cigna's ethics policy, managed the health care triage team, oversight of SIU compliance and training, and managed the technology solutions used by SIU. Currently he oversees SIU compliance and all claims investigations pertaining to U.S domestic and international benefit product lines including disability, life and accident policies. He holds a Bachelors of Science degree in Accounting from Southern Connecticut State University and earned a Master’s of Science degree in Economic Crime Management from Utica College.
Christa Jewsbury, JD, CFE — Director, Special Investigations Unit, Humana
Christa joined Humana's Special Investigations Unit as its Director in March 2014. Prior to joining the SIU, Christa served as the Manager of Humana's Internal Audit Department's Fraud & Investigations Team. Christa also spent several years with the Indiana Medicaid Fraud Control Unit as a Deputy Attorney General, where she litigated parallel fraud, licensing and patient abuse cases and coordinated fraud investigations with outside agencies.
Donald Wunderlin, AHFI, CFE — Investigative Oversight Branch Chief, U.S. Department of Defense, Defense Health Agency
Don Wunderlin is the Chief of the Investigative Oversight Branch for the Defense Health Agency Program Integrity Office. Don came to DHA Program Integrity in 2007 after spending several years with the Department of Veterans Affairs Program Integrity Office. Don has worked in the health care industry in a variety of critical care areas, including Critical Care Air Transport, ER, Trauma ICU and the NICU/PICU as a Registered Respiratory Therapist/Neonatal Pediatric Specialist. He also holds credentials as an Accredited Health Care Fraud Investigator and a Certified Fraud Examiner.
David Popik, CFE — Senior Director, FWA Operations, FloridaBlue
Dave Popik, CFE, is a seasoned healthcare executive with 24 years of experience fighting fraud, from enforcement and healthcare informatics to information technology and business administration. As Florida Blue's Senior Director of Special Investigations and Physician Ancillary Services, he is directly responsible for all internal and external fraud investigations, risk management, and data analytics to identify and prevent fraud, waste and abuse. Previously, Dave was a director at UnitedHealth Group, where he played a vital role in the payment integrity program. He is also a National Board Member and Secretary of the National Health Care Anti-Fraud Association.