FWA Program Pitfalls 2
In the second video in our series, Jala Attia, President of Integrity Advantage, discusses the second pitfall in FWA programs: equating compliance with success.
Hi everybody. If you missed our webinar, we talked about three fraud, waste, and abuse program pitfalls and how to overcome them. And I’ve already recorded the video for pitfall number one. We’re going to talk about pitfall number two right now, which is thinking that compliance always equals fraud, waste, and abuse program success.
And we equate this to sort of Mount Everest. Compliance and ensuring that you have a compliant program is sort of the base camp, right? You get to the base camp, but you’ve got further to go. You’ve got to go to the peak. You want to go to the summit. And so all these things sort of play into the growth of your program. So building a strong case management capability or ensuring that you have that, making sure that you’ve got strong vendor oversight, having dedicated staff to support your fraud, waste, and abuse program efforts, data analytics, education, certification, organizational collaboration, ROI, etc. All of these things, envision climbing Mount Everest. You get to base camp, that’s compliant. You want to get to the summit, you want success in the program, you need to be able to tackle base camp one, base camp two, all the way to the top.
And so when you think about this, make sure that you’re prioritizing your key goals. If compliance is your key goal, fantastic. Make that the baseline and then build from there. If referrals or ensuring high ROI or ensuring organizational collaboration, if those are all really, really important, prioritize them. Prioritize them and ensure that they’re on the pathway to that program success.
How do you overcome this pitfall? How do you overcome just getting to base camp and staying at base camp? You elevate the knowledge within your organization. You communicate, you share what your challenges are with industry experts, you share it with your peers. Don’t set it and forget it. Your processes will change, your program will change. That’s ok. That’s totally normal. You want it to change. You can’t be stagnant so continue to grow that. And then finally, get an objective assessment of your program. Get it from internal stakeholders, get it from external stakeholders, get it from your peers, hire a team. This is the type of thing that allows you to step back because you’re close to your program. You may not see all the challenges that exist.
So, pitfall number two, ensuring that you’ve got a compliant fraud, waste, and abuse program does not always ensure success. So make sure that you build a foundation of compliance to grow into a successful 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.