What does "Reimagine the Value of Your FWA Program" mean?
Does your organization fully realize the value of the FWA program or SIU team? Many organizations do not leverage the wealth of knowledge and skill that is housed within your FWA team to make improvements across the organization. There are a number of business units within a payer that can benefit from what is learned from investigating healthcare FWA. Watch our video to learn more.
Transcript:
Reimagine the Value of Your FWA Program
What do we mean when we say “reimagine the value” of your fraud waste and abuse team or your SIU?
There is a decades-long belief in the industry that the SIU is a secretive place where you sent investigations. The team would perform the investigations, but then you heard nothing back; the team was confined to their box of SIU. That idea has been a misnomer for many years, and we want to dispel that myth.
You should be expecting more from your fraud, waste and abuse program.
When we say, “reimagine the value of your FWA program,” we literally mean look at it in the context of the whole enterprise and how it can add value across the enterprise. For example, in many instances the team that performs some of the investigations can tell when there is a claim edit that needs to be implemented. There may be a medical policy that your plan is lacking, where others may have a policy in place. They look at this across the organization and they are able to make recommendations to improve that. They are able to identify risks, quantify what those risks usually look like, and make recommendations for improvement. We have seen that it is tremendously successful when organizations actually allow their fraud waste and abuse program teams to be involved in other components of the organization. We find that we are helping vendor management understand what they are missing in the agreements that they have in place with their subcontractors or their vendors that are potentially going to impact the organization.
Reimagining the value really means not letting an SIU specialist’s skill set sit in a box. Let the SIU out. Let them provide insight and clarity around things that they are seeing within their investigations that now impact the enterprise as a whole. We guarantee that you will see value. Almost every organization that sees their SIU or fraud waste and abuse team in that way will find that they add value across the organization and tremendous savings as well. If you have any questions, please reach out, we love to hear from you. Thank you!