Fighting Health Care Fraud With Solutions from Thomson Reuters and i-Sight

The signing of the Universal Health Care Bill in the US brought to light the need for solutions to detect and prevent health care fraud.

Posted by Joe Gerard in Article on September 9th, 2010
The signing of the Universal Health Care Bill in the US brought to light the need for solutions to detect and prevent health care fraud. Payment recapture initiatives were revamped earlier this year throughout the US and are predicted to put at least $2 billion over the next three years back into taxpayer pockets. As controls surrounding health care fraud detection and prevention are tightened, it’s likely that there will be a rise in the number of health care fraud related investigations. Employers, medical professionals, insurance companies and all other parties in the health care industry need to be prepared to handle increasing case loads.

Thomson Reuters offers a best in class solution for health care fraud detection, abuse and waste, while i-Sight Case Management Software from Customer Expressions is a best in class solution for managing health care fraud investigations. Over the next few months, we will be on the road with our friends at Thomson Reuters, attending a number of health care fraud conferences throughout North America.

Ray Gerard, President at Customer Expressions stated:

“Health care fraud is an epidemic. In 2009 alone, an estimated $54 billion was lost due to improper Medicare and Medicaid payments. As efforts to tighten health care fraud controls in the US are put into place, technology and software solutions, including i-Sight Case Management Software, can be used to identify repeat offenders and investigate health care fraud allegations.”


Where to Find Us

A variety of organizations have been created to bring awareness to the issue of health care fraud. Each year, many of these groups hold conferences to bring health care professionals and industry leaders together with companies- such at i-Sight and Thomson Reuters, that have developed solutions targeted specifically at fighting health care fraud. Here’s a list of the upcoming conferences organized by these groups that we will be co-exhibiting at with the Thomson Reuters team:

  • The 26th Annual NAMPI Conference, hosted by the National Association for Medicaid Program Integrity. The conference takes place in New Orleans, Louisiana from September 12-15.
  • Raise the Ante Against Health Care Fraud, the Annual Conference held by the Canadian Health Care Antifraud Association. The conference takes place on September 14th and 15th in Niagara Falls, Ontario, Canada.
  • The 2010 NASMD Fall Conference, held by the National Association of State Medicaid Directors, from November 8-10 in Arlington Virginia.
  • The National Health Care Antifraud Association’s (NHCAA) Annual Training Conference. The conference is held in Las Vegas Nevada from November 16-19.

Some of the topics to be presented and discussed at the conferences this year include:

  • Conducting health care fraud investigations and report writing.
  • Top health care challenges and risks.
  • Health care fraud in the UK, US and Canada.
  • Investigating disabilities and health care fraud.
  • Health care fraud schemes and trends
  • Medical identity theft.
  • Impact of fraud on the health care industry.

Joe Gerard
Joe Gerard

CEO, i-Sight

Spend my days showing off the i-Sight investigative case management software and finding ways to help clients improve their investigations. Usually working with corporate security, HR & employee relations, compliance and legal teams.

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