Educational Webinar in NHCAA’s Virtual Training Program

We’re pleased to announce that 4L Data Intelligence recently participated as a partner speaker in a webinar hosted by the National Health Care Anti-Fraud Association (NHCAA) as part of their “Schemes for Health Care Fraud Investigators & Analysts: A Virtual Training Program.”

The live webinar, titled “Early Detection of Provider Collusion Schemes,” was held on Friday, May 24th, and included an informative Q&A session. Participants and attendees found the session highly educational, and students earned valuable credits for their participation.

As one of NHCAA’s trusted solutions partners, we had the opportunity to share our insights in this 60-minute training session for NHCAA members. NHCAA webinars, including this one, are worth 1 Continuing Professional Education (CPE) credit, providing professionals with an essential opportunity to gain critical anti-fraud knowledge while advancing their credentials. This aligns with NHCAA’s commitment to offering significant benefits to its members, which include health insurers, governmental entities, and other companies and organizations dedicated to combating health care fraud.

Our presentation focused on taking a provider-centric approach to Fraud, Waste, and Abuse (FWA) prevention. We introduced the concept of utilizing comprehensive Know Your Provider (KYP) data and leveraging cutting edge AI technology to do continuous behavioral, relational, and pattern analysis of all claims and providers. This approach aims to detect provider collusion schemes as quickly as possible to prevent losses in near-real time.

Key learning objectives of the webinar included:

1. Understanding why a provider-centric FWA detection and prevention approach increases fraud and collusion detection
2. Learning how to use KYP to identify provider business ownership and related party interests in near real-time for early fraud detection and prevention
3. Exploring what investigators can do manually versus what can be achieved with advanced AI or machine learning technologies to enhance collusion scheme detection

The session highlighted how evolving from a claim data-centric to a provider-centric methodology increases the effectiveness of FWA detection and prevention.

Participants gained insights into:

• The importance of continuous monitoring and analysis
• Leveraging advanced KYP solutions for comprehensive provider insights
• The role of AI and machine learning in enhancing fraud detection capabilities
• Practical applications of provider-centric approaches in real-world scenarios

4l Data Intelligence is proud to contribute to the ongoing education of program integrity and healthcare fraud investigators. In line with our vision to help reduce $1T of fraudulent, wasteful, or abusive costs by 2030, and our mission to use Integr8 AI Risk Detection™ technology for good, we aim to empower professionals with the knowledge and tools needed to combat fraud more effectively. By sharing our expertise in data intelligence and provider-centric methodologies, we strive to protect consumers and maintain the integrity of our healthcare system while helping reduce costs and improve service quality.

For those who missed the live session, we encourage you to check with NHCAA about the availability of session recordings or future offerings of this webinar.

To learn more about our provider-centric data intelligence solutions and upcoming educational opportunities, please visit www.4LData.com or contact fast@4LData.com.