In this month’s issue:

• Make Fraud Control Everyone’s Job
• Wheelchair Fraud Update
• Let’s talk about Data Mining
• Upcoming Events

Make Fraud Control Everyone’s Job

Five organizational problems reduce the effectiveness of fraud control:

1. Not my job
2. Don’t know how to recognize fraud
3. Nobody clearly in charge
4. No clear way to report suspicions
5. No feedback about what happened with a case

Read Make Fraud Control Everyone’s Job to find out how to fight these problems.

Wheelchair Fraud Update

Wheelchair fraud has been in the news a lot lately. Why is it suddenly gaining attention? In Two Brothers Plead Guilty to Wheelchair Fraud I update you on what’s happening in Medicare’s wheelchair fraud cases and analyze why this issue becomes newsworthy every few years. Finally, I give you three tips on how to improve how we keep wheelchair and other fraud under control.

Let’s talk about Data Mining

I’ve been talking to a lot of data mining vendors lately. We know data mining will play an important role in the future of healthcare fraud control, but how do we get there? The number one problem is getting good data to use for training and testing predictive models. How can we work with healthcare payers to get good data? Join me in discussing Data Mining in my data mining forum Please add your comments. They may appear immediately but will be on the forum in less than 24 hours. You can also call me to discuss this topic or others 707-636-0418.

Upcoming Events

I hope to see you at these upcoming events (if you are planning to attend, please let me know):

ACFE Insurance Fraud Conference: Think Like a Criminal
Mon, 08/23/2004 - 2:00pm Location: Hartford, CT