Advance Medical Insurance Fraud Detection, Prevention and Data Analysis Techniques

Held On: 04th Nov to 05th Nov, 2018, Hotel Towers Rotana Dubai | UAE

Course Benefits

Completion of this course will provide attendees with an all-inclusive understanding of the scope of healthcare insurance fraud, ranging from the simplest situations to complex and sophisticated healthcare/insurance fraud crimes.
By the end of course, specifically, the attendees will have the know-how to:

  • Nature and types of healthcare/insurance frauds.
  • Healthcare/Insurance fraud: Implications for prevention, detection, and investigation.
  • Healthcare/Insurance fraud in International markets.
  • Knowing market players within the healthcare continuum in context with healthcare insurances.
  • How to recognize & avoid healthcare/insurance fraud.
  • Role of ethics in healthcare/insurance fraud prevention.
  • Components of the data mapping and data mining process.
  • Health Insurance Portability and Accountability Act (HIPAA) of 1996.
  • Audit guidelines in using PHI.
  • Healthcare/Insurance Fraud: Penalties & Consequences.
  • Normal infrastructure and anomaly tracking systems.
  • Data analysis models and clinical content data analysis.
  • Data-driven Health decisions in an e – Health environment.
  • Analytic tools and audit check lists.
  • Electronic Health Records and health offering vulnerabilities.
Course Outline
Who Should Attend?
  • All levels of auditors, investigators and prosecutors working in the healthcare/insurance fraud area
  • Executive Management of insurance or reinsurance companies and hospitals
  • Certified Fraud Examiners (CFE)
  • Certified Information Systems Auditors (CISA)
  • Insurance Claims Adjudicators
  • Special Investigator Unit Directors/Auditors
  • Medical Claims Auditors
  • Compliance 
  • Professionals looking to expand their knowledge of insurance fraud detection and prevention
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