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Last July, Secretary Sebelius announced a data prospecting initiative where the government introduced new fraud detection measures that are based on predictive modeling. Once the government "knows where to dig", it can embark on a full data mining exercise, none more illustrative than the recent Department of Justice investigation relating to Implantable Cardiac Defibrillators. Both the RAC and ZPIC audits are also based on data mining and data prospecting, and the government is recovering millions of dollars in overpayments through these audits.
For providers, data mining their own data trends and claims has now become a necessity - but like any compliance project, there are several traps for the unwary lurking beneath the surface. During this webinar, Bernie Ford and Rebekah Plowman explore the thoughtful and constructive tools providers can employ in their own data mining exercises to help avoid unnecessary cost and liability in the future.