Healthcare Fraud Shield Survey and Prize!

In This Issue

Press Release: Healthcare Fraud Shield Integrates TransUnion TLOxp Into FWAShield Platform

Healthcare Fraud Shield's Fully Integrated Suite of Products & Services. Check out our fully integrated Prepayment system. Contact Healthcare Fraud Shield!

Check out Healthcare Fraud Shield's Upcoming Presentations

Healthcare Fraud Shield Survey!

Did you know Healthcare Fraud Shield offers SIU Services and SIU Training?

Press Release: Healthcare Fraud Shield Integrates TransUnion TLOxp Into FWAShield Platform

Interested in working for Healthcare Fraud Shield's SIU?

Healthcare Fraud Shield's Upcoming Presentations
* NHCAA-Regional NETS in New Orleans

Lead Validation: The lead validation process is a critical step between lead identification and case assignment to an investigator. Understand how to prioritize leads to ensure proper asset allocation and investigator case mix. Be able to identify factors that may influence lead validation and assignment.

Session by: Kenneth Cole, AHFI, CPC, CFE -Supervisory Investigator, Healthcare Fraud Shield

Healthcare Fraud Shield's Fully Integrated Suite of Products & Services

QueryShield?

To see an overview of Healthcare Fraud Shield Products and Services click HERE to schedule a demo.

Product Highlight-

PrePayment

Healthcare Fraud Shield developed a predictive prepayment FWA system, PreShield? that is fully integrated with our postpayment and case management systems. PreShield? is designed to:

Focus resources on the most viable and prospective suspicious claims using real-time data
Daily feeds that can be tailored based on claim attributes, staff availability, staff expertise, company initiative, and regulatory alerts and guidance
Increase ROI
Reduce dollars lost by preventing fraudulent claims to be paid
Reduce the level of effort needed by investigators/analysts to find the fraudulent claims by reducing the excessive false positives returned by other fraud systems, allowing the staff to focus on the tangible suspicious claims/cases
Clear, concise and detailed alerts that provide reference points and helpful training on complex fraud topics and new schemes
Increase the intelligence of the product over time based on prior results, strengthening the use and efficacy of predictive analytics Work seamlessly with your postpayment and case management system

Help a Healthcare Fraud Shield Reader!

One of our readers could use some assistance from our network of fraud experts. If anyone has information pertaining to the question below, please email us at [email protected]

"Is a Managed Care Organization mandated to go after Medicare overpayments when they are dealing with paying out co-payments for a non-participating provider?"

Join Our Mailing List

Coding Corner

Send a coding question to our coding experts to [email protected]. If your question is selected, you will be eligible for a prize and we'll publish the question along with the answer in one of our weekly articles.

Click here to see all of the prior questions and answers!

Welcome to Healthcare Fraud Shield's newsletter. This week we ask our readers to help us gather information by participating in our survey. Participants will be eligible for a prize!

Check out our archived articles on the Healthcare Fraud Shield blog where you can access all of our previous articles.

Sincerely,

Healthcare Fraud Shield

Healthcare Fraud Shield Survey!

Click HERE to participate in the survey. All participants will be entered into a random drawing for a prize!

Healthcare Fraud Shield appreciates your feedback and is always looking to ensure we are providing the most valuable information to our readers.

If you have any other questions or comments, please feel free to send them to [email protected].

Healthcare Fraud Shield offers an integrated FWA platform combining prepayment, postpayment, an ad-hoc querying tool and case management in an all-in-one solution. To see an overview of Healthcare Fraud Shield Products and Services click HERE to schedule a demo.

About Healthcare Fraud Shield

Healthcare Fraud Shield is based in Chesterfield, Missouri and provides advanced FWA (Fraud, Waste and Abuse) detection systems to the healthcare industry. The company's services enable investigators to quickly identify suspicious activity and accurately pinpoint fraud. Our unique technology allows our customers to maximize loss prevention and recovery efforts with a substantial ROI.

16052 Swingley Ridge Road, Suite 200, Chesterfield, Missouri 63017

Phone: 888-333-8140 Email: [email protected]