Consulting & Program Development
Organizations have relied upon our expertise to provide guidance and support for fraud, waste and abuse initiatives. While these programs vary in size and scope, we have the experience to support a variety of organizations such as payers and technology vendors.
Our consulting and program development services include:
- Special Investigations Unit (SIU) or FWA program assessment and recommendations using industry benchmarks and best practices
- Audit prep support including assistance with ensuring program effectiveness through tracer audit methodology
- SIU / FWA program buildout or revamp for Medicare, Medicaid, and Federal Employee Health Benefits (FEHB) lines of business
Evaluation and/or creation of fraud plans, policies and procedures, and work flows
RFP (Request for Proposal) and vendor selection support including drafting of questions and evaluation of technology solutions
- Assistance for technology application implementation including customization based on client's needs
- Preparation of annual work plan and risk assessments
- Policy gap analysis and recommendations to rectify weaknesses
- Coaching support for new FWA SIU leaders
And although we are tech-agnostic, we know the tremendous value of technology applications in fighting fraud, waste and abuse which is why we also provide support to vendor organizations. Our support for technology vendors includes:
- Support for bids that require FWA service support in addition to licensing technology solutions
- An understanding of the FWA market needs and requirements
- Position assessment of technology application capabilities
- Assistance in operationalizing new solutions in the market
- Suggestions for application interface and user-centric design
- End-user expertise and perspective