FWA Program Pitfalls 3

In the third video in our series, Jala Attia, President of Integrity Advantage, breaks down how a lack of organizational buy-in can be a huge issue for FWA teams.


Okay, pitfall number three: when we talk about the top three critical pitfalls that we see in programs (fraud, waste, and abuse programs), especially when we do assessments, the third one is lack of organizational buy-in. This one’s tough because we’ve worked with some plans where the org was completely bought in to the fact that we needed more structure, more support, more investment into the FWA program. We’ve worked with organizations that don’t necessarily see that. That think just being compliant is enough.

Ask yourself: How much of your FWA program do you share with your organization?

We’re not saying details. We’re not saying get down to the roots of it and say, “here’s a case about this, that, and the other thing.” What we’re saying is, their level of investment and buy-in potentially is going to be commensurate with what you choose to share with the rest of the company. So, if you say, “I don’t want them seeing what we do over here,” you may not get the level of investment or buy-in into your team that you want or that you need. But if you can share a little bit more and align with the organizational goals, you tend to get a lot more interest, because our work is really, really interesting. It’s really, really fun. I don’t think I’ve ever talked to somebody and told them what we do where they’re just like, “this is completely boring.” We love what we do, and other people tend to gravitate towards it because we feel this excitement for it.

So, share a little bit above what you think you need to share. Get organizational buy-in by engaging with the rest of the organization. Don’t live in a black box. Free the SIU, right? Get out of the SIU and show the rest of the organization the value that you bring because we know. We get to see the really interesting things that happen after claims have been processed, after payments have been made. We have a very interesting birds eye view. So we need to use that in order to elevate our position within the organization and get a seat at the table for many of the conversations that lead to organizational buy-in in the FWA program. Make sure that you overcome it by having conversations. Invite that conversation.

A long time ago I made a video about inviting the conversation. I’m saying it again: invite the conversation. I’m not saying give granular details about every case that you work. I’m saying have a conversation, build relationships and collaboration within the plan. It’s one of the best ways to elevate the success of your program.


Integrity Advantage is the way healthcare payers reimagine the value of their fraud, waste and abuse program.

We provide FWA services to payers around the country. If you need a program assessment, program growth strategy, investigations, medical reviews or training support -- reach out today.

We are a certified Women’s Business Enterprise (WBE) and an Economically Disadvantaged Woman Owned Small Business (EDWOSB).

For more information click below, call us at 866-644-7799 or email info@integrityadvantage.com.

Jala Attia