The IntegrityM Blog
Five Traits of an Effective Healthcare Data Analyst
The key to successfully harnessing the power of data in healthcare is to analyze, interpret, and share the results in a way that is meaningful and effective for decision makers. Those located at the front lines — healthcare data analysts — play a central role in this process. As the healthcare industry rapidly changes, data […]
Efficiently Evaluating “Big Data” for Medicare Fraud Detection
With over 2 billion Medicare claims available for analysis since 2006, the term “Big Data” has no better application than in the health care industry. The opportunity for meaningful analyses resulting from big data is limitless. However, finding the best method for combing through Medicare claims data in an efficient manner can be tricky since […]
Statistical Bias in Health Care Fraud Detection and Prevention Systems
Organizations across the health care program integrity industry are using analytic solutions for fraud detection and prevention that intake and analyze data to signal the threat of fraud. These solutions can process huge amounts of data from multiple sources and remove much of the human element of potential fraud detection. When we think about these […]
Best Practices for Conducting Healthcare Fraud Investigation Interviews
Healthcare Fraud Investigators provide a valuable resource in the fraud analysis process. They perform in-depth evaluation and analysis of potential fraud cases and requests for information using claims and other sources of data. One method for gathering information during an investigation is performing interviews. Along with analysis of records and other data, conducting fraud investigation […]
Understanding the Telehealth Claims Landscape
Telehealth is expanding rapidly and transforming healthcare. According to the Medicare Payment Advisory Commission, the number of telehealth visits grew by over 500 percent from 2008 to 2014. Additionally, many commercial insurers cover — and many health systems offer — a variety of telehealth services. The industry has seen impressive advancements in telehealth technology, and […]