Successful fraud control never results from a set of algorithmsit depends upon shifting organizational culture. Our workshops help participants understand the incentives that drive fraud, so they can take a proactive role in fighting fraud.

We’ll prepare custom workshops to meet your needs. Just contact us by phone or email.

Robin at Managed Care Conference

Sample Topics

Best Practices in Medicaid Fraud Control

How to implement better healthcare fraud controls

The War on Fraud: A New Battle Plan

How to implement better healthcare fraud controls

Managing Managed Care Fraud

What every managed care organization needs to know to control fraud

Chase the Fraudster Back to His Lair: What We Can Learn from the Bad Guys

As soon as you cut off access to one loophole, fraudsters will find another. You can use claims data to follow abusers to their new scams and their fellow abusers.

Incentive to Steal: Fraud-proof Your Policy Initiatives

It can take months to implement new policies and just days for fraudsters to find loopholes to abuse. Learn to build prevention into your policies instead of incentives for fraud.

Your Role in Stopping Fraud

How all your employees can fight healthcare fraud and why they should.

Sample Agenda

Best Practices in Medicaid Fraud Control

This half-day presentation can be customized to bring your staff up-to-date on the information they need most.

• Measure Fraud - What’s working and what’s not
• Beyond HIPAA [1] - How Internal Controls Protect You
• Make Fraud Control Everyone’s Job - Claims, enrollment and provider staff come into contact with fraud, help them learn to spot it
• Chase the Fraudster - Learning from the Bad Guys

Sample Keynote

Prevent Fraud: Think Like a Criminal

Criminals are constantly looking for new ways to steal. They review every provider bulletin and policy announcement looking for new loopholes. They test each potential weakness they can think of, looking for the perfect scam. To have any chance of stopping fraud, we must look at each of our policies with a criminal eye. Participants in this session will:

• Learn how quality incentives and other policies can be exploited by criminals
• Find fraud opportunities in real policy proposals
• Identify policy changes that would prevent real fraud cases

Robin Mathias

You can read articles about recent and future presentations at Public Appearances [2].