Course Benefits

Completion of this course will provide attendees with a better understanding of the scope of healthcare insurance fraud, and how to prepare a case with the proper order of  interviews, ranging from the simplest situations to complex and sophisticated healthcare/insurance fraud crimes.  We will also discuss the differences between interviewing and interrogation and the proper setting for each. By the end of course, specifically, the attendees will have the knowledge to:

• Identify various types of healthcare/insurance fraud and conduct effective interviews
• Understand various Healthcare/Insurance Fraud Penalties & Consequences
• Learn how to detect deception in the interviewee during an interview
• Understand how the use of kinesiology aids in interviews
• How to plan for and create the interview setting:  where, when, how
• Key techniques for interviewing from the experts
• Recognize what types of approaches to use for various witnesses and subjects
• Recognize and utilize behavioral clues in key interviews
• Synthesize analytic results of the data in the investigation for use in the target interview
• Learn from case studies on the “do’s and don’ts” in interviewing and what brings success

Target Audience

• Investigators and Auditors in the Healthcare domain
• Certified Fraud Examiners (CFE)
• Certified Information Systems Auditors (CISA)
• Insurance Claims Adjudicators
• Special Investigator Unit
• Directors/Auditors
• Medical Claims Auditors       
• Attorneys
• Third Party Administrators
• Professionals who want to expand their skillsets in interviewing techniques
• Fraud Analysts
• Compliance analysts and managers
• Internal and external auditors
• Medical audit/claims        
• Consultants
• Those attendees that are new to the fraud and abuse world

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