Using Data Analytics to identify Fraud, Waste and Abuse (FWA) is vital to reducing risk of financial losses and potential for patient harm. However, there are hidden risks outside the claims data that could lead to or be indicators of potential FWA. After Providers and Suppliers are credentialed things can change regarding their status, such as, but not limited to, recent sanctions, criminal activity, and where they are located. This information, outside the claims data, can create risk and reduce the ability to effectively evaluate risks.
Join us for our upcoming webinar as we discuss:
- The financial impact of FWA on Healthcare
- Leveraging 3rd party data to detect behavior outside the claims data to improve the ability to identify and address risks sooner
- Improve Provider and Program Compliance to protect healthcare dollars and members.
Government Regional Sales Manager
David Duhaime is the National Account Manager for US Healthcare Accounts and is responsible for leading a team of Account Executives at Thomson Reuters with a focus on Health Plans, State Medicaid Program Integrity and Federal accounts including VA and Medicare. He is a seasoned professional with more than 30 years of experience in healthcare fraud investigations as a former SIU Director with Anthem BCBS, Program Director with a Zone Program Integrity Contractor (ZPIC) and former Law Enforcement as an Investigator with NYS State Medicaid Fraud Control Unit (MFCU). David holds a bachelor’s degree in Criminal Justice from Norwich University, a Master’s degree in Business Administration from Jack Welch Management Institute.