Do you have feedback or want us to write about a particular topic that interests you? We’d love to know! Send us a note.
Most FWA programs rely on recoveries and savings as the measure of success. But there is another critical component that's a hidden risk and amounts to big dollars: Prevented Losses. We are bringing prevented losses to the forefront, not just in concept, but also in terms of the financial impact on healthcare payment integrity. This article discusses challenges that continue to exist and what we need to do as an industry in order to continue to evolve the value of our FWA programs.
Read MoreMany investigative teams fear being expendable. Some resist new technology capabilities because they feel threatened. This fear is rooted in process - steps they are expected follow when working investigations. This video prompts the question - are you building a team of thinkers or a team of robots?
Read MoreNo matter what tools you may use, nearly everyone will use Excel files of claims data at some point in the process of doing an FWA investigation. This video shows you a way to isolate boiler plate billing using a cool Excel hack.
Read MoreOne common question we all grapple with is how long we should leave a provider on prepay? Watch this video to learn some of our tips related to prepay monitoring of providers and what you should do if you aren't sure how to handle a provider that consistently bills inappropriately.
Read MoreIn this short video, Jess provides a helpful trick for formatting dates in excel.
Read MoreOutsourcing is often thought to be a dirty word. But don’t be fooled - outsourcing can be a cost effective, high impact investment into the success of your team. Since many of you know this is precisely the business we are in - we decided to discuss some common misconceptions we’ve heard over the years and the many lessons learned as a result.
Read MoreSurviving in the world of FWA is somewhat like surviving in the wild. Without some essential elements, your shot at success decreases. Don’t go on the journey alone. Download Integrity Advantage’s SIU Survival Guide and read about ten critical elements that you can implement to set up your FWA program for success. In it, we share tips and lessons learned from many years of hands-on experience working with payers of various sizes and different lines of business. Take our guide with you on your journey and reimagine the value of your FWA Program!
Read MoreWhen holding your FWA team accountable for identifying enterprise risks, setting the goal is only the first step. Many leaders struggle with step 2 - which is "how" do we measure this? In this video, Jala talks about the key components to include when considering the goal of risk identification.
Read MoreWhen we say "invite the conversation" there are some things that you should keep in mind and prepare to share about the FWA Program and how it contributes to the organization. Do you know what those are? In this video, Jess let's you in on a few things that you should be ready for when you invite the conversations.
Read MoreMany FWA leaders wonder how to get their company to reimagine the value of their team. This video provides some quick tips on ways to make your organization aware of the value found on your FWA team. It could be as simple as inviting the conversation and questions!
Read MoreRead our goal setting guide to learn 5 key goals your FWA program should have, how to set them up for your team and tips for measuring them throughout the year. We describe individual and team goals, provide examples of each and share ideas about how to best implement them for the success of your program.
Read MoreDoes your organization fully realize the value of the FWA program or SIU team? Many organizations do not leverage the wealth of knowledge and skill that is housed within your FWA team to make improvements across the organization. There are a number of business units within a payer that can benefit from what is learned from investigating healthcare FWA.
Read MoreThere are a number of best practices across the healthcare payer space that improve overall collaboration of fraud, waste and abuse efforts. In this video, Jess shares one of those best practices and some things to think about when deciding whether to implement this at your organization.
Read MoreSIU Outsourcing has a ton of flexibility and can help the SIU unlock tremendous efficiency.. However, some perceive it as a threat. Read our article to understand the 4 most common myths of SIU outsourcing and how dispelling these myths can greatly benefit your organization.
Read MoreWhat should you do if you haven't prepared for COVID's impact to your claims related to fraud, waste and abuse (FWA)? Jala Attia takes us through three things that your health plan can do to minimize the impact of the pandemic related FWA on health payers claims.
Read MoreWhen health plans are looking for new technology capabilities to fight fraud, waste and abuse, specialized consulting can be a great help. This article outlines three key criteria to consider when navigating the maze of fraud detection options.
Read More
