Hi [[ session.user.profile.firstName ]]

General Dynamics Health Solutions Channel

  • Date
  • Rating
  • Views
  • Detecting Fraud, Waste and Abuse in Laboratory Testing
    Detecting Fraud, Waste and Abuse in Laboratory Testing
    Gerry Petrowski and Suzanne Baker, General Dynamics Health Solutions Recorded: Sep 20 2017 57 mins
    Urine drug screening and genetic testing are ongoing areas of concern for fraud, waste and abuse (FWA) investigators. This session will familiarize investigators with common schemes found in laboratory claims data and provide effective methods for detecting, preventing and responding to healthcare fraud. Additionally, this webinar will examine documentation requirements to support payments for drug screenings, as well as review the key components necessary to conduct a thorough medical review and to write a clear, concise audit findings report.
  • Healthcare Fraud Driving Organized Crime: Examining Sources of Illicit Income
    Healthcare Fraud Driving Organized Crime: Examining Sources of Illicit Income
    Erin Picton, AHFI, Investigations Manager, and Mark Starinsky, Service Delivery Manager, General Dynamics Health Solutions Recorded: Jul 26 2017 56 mins
    This session will familiarize investigators with the connection between healthcare fraud schemes and financial crimes, and fraud’s increasing importance in organized crime. This webinar will examine case study examples and provide effective techniques for detecting, preventing and responding to healthcare fraud, as well as practical advice for leveraging law enforcement partnerships in support of identification and recovery of misappropriated assets.
  • Dermatological Coding Complexities and Opportunities for Fraud, Waste and Abuse
    Dermatological Coding Complexities and Opportunities for Fraud, Waste and Abuse
    Lindsay Surynt, Investigator, and Katherine Bass, Investigator, General Dynamics Health Solutions Recorded: Jun 29 2017 53 mins
    Dermatology is a complex clinical specialty comprising hundreds of procedure codes for surgical services related to lesion removals, biopsies and excisions. This session will familiarize investigators with dermatology’s complex clinical coding issues by reviewing accurate reporting requirements and specific sections of the National Correct Coding Initiative, or NCCI. Our experts will also demonstrate applicable data mining techniques.
  • Opioid Abuse: Scripting the Way to Addiction
    Opioid Abuse: Scripting the Way to Addiction
    John Maguire, M.D., Chief Medical Officer and Mark Starinsky, AHFI, CFE, CHC, Service Delivery Manager, GD Health Recorded: May 24 2017 58 mins
    With dramatic increases in prescription opioid availability, usage and spending, this session will explore popular fraud schemes associated with drug abuse and discuss effective data mining to identify such behavior. This session will help investigators combat the opioid epidemic through discussion of contributing factors of opioid availability, common fraud schemes used by drug seekers and Federal and State intervention strategies aimed at reducing prescription opioid abuse.
  • Demystifying Statistical Sampling for the Fraud Investigator
    Demystifying Statistical Sampling for the Fraud Investigator
    Mark Starinsky, Service Delivery Manager, General Dynamics Health Solutions Recorded: Mar 30 2017 68 mins
    With attributes, variables and clusters, even the vocabulary of statistical sampling can be challenging to the lay investigator. However, proper understanding and command of these terms is essential to mastering the tools and techniques necessary for preparing statistically-valid random samples. This skills-based webinar will review important sampling terminology, the benefits and applications of sampling to healthcare audits and investigations, and include demonstration of preparing a sampling data set with OIG’s commonly-used RAT-STATS.
  • Using Post-payment Insights to Build Strong Pre-payment Claims Review Programs
    Using Post-payment Insights to Build Strong Pre-payment Claims Review Programs
    Erin Picton, AHFI, Investigations Manager, General Dynamics Health Solutions Recorded: Dec 14 2016 51 mins
    Building and maintaining an effective pre-payment claims review program can be challenging without leveraging prior inappropriate billing patterns or checks against fraud trends that were previously identified during post-payment claims reviews. In this session, participants will learn the importance of gathering and leveraging information from post-payment reviews to significantly strengthen pre-payment review programs, as well as the use of ICD-10 codes and outliers that can help generate new leads based on current billing trends and better address claims system vulnerabilities.
  • General Dynamics IT: 5-Step Process to Secure Cloud Migration
    General Dynamics IT: 5-Step Process to Secure Cloud Migration
    Srinivas Singaraju, Chief Architect, Cloud Solutions, General Dynamics IT Recorded: Nov 17 2016 30 mins
    Cloud computing shares distributed resources at various levels (SaaS/PaaS/IaaS), and can present challenges in operating a secure environment, forcing CIO’s and agency heads to address questions about cloud migration, such as: What will be the impact on my agency’s legacy applications? What challenges do I need to overcome to be successful? What strategies will help my agency overcome those challenges? Learn how to migrate to the cloud through a 5-step process that embeds security at every stage, ensuring a successful cloud migration.
  • Preparing Effective Reports: Have You Got the “Write” Information?
    Preparing Effective Reports: Have You Got the “Write” Information?
    Mark Starinsky, AHFI, CFE, Program Manager, General Dynamics Health Solutions Recorded: Nov 10 2016 60 mins
    As budgets decline and workloads increase, managers need information presented in a clear, concise way to make decisions.
  • Maximizing Medical Records Retrieval to Improve Reported Rates
    Maximizing Medical Records Retrieval to Improve Reported Rates
    James Ullom, MRR Services Manager, General Dynamics Health Solutions Recorded: Oct 13 2016 40 mins
    Retrieving medical records from providers can be the most challenging aspect of the HEDIS hybrid measure season and its success can have the most direct impact on hybrid rates. Learn ways to improve your chart retrieval processes to increase your success at receiving your member’s medical records during the busy HEDIS season.
  • Coding in Obstetrics: Identifying Improper Payments Within OB/GYN Claims Data
    Coding in Obstetrics: Identifying Improper Payments Within OB/GYN Claims Data
    Melissa Dupre, RN, CMSRN, CPC, Program Manager, Lindsay Surynt, Investigator, and Kaytlin Ceron, Investigator, GD Health Recorded: Aug 10 2016 51 mins
    In this session, participants will gain a better understanding of documentation and coding requirements for OB/GYN services in order to identify potential areas of fraud, waste and abuse.

Embed in website or blog