AI: A Good Tool to Combat Bad Actors in Healthcare
AI can be a highly effective tool for plans aiming to reduce fraud, waste and abuse, but only if it is combined with investigative intelligence.
Erin Rutzler</a> is Vice President of Fraud, Waste and Abuse at <a href=https://medcitynews.com/author/erutzler/"https://www.cotiviti.com/">Cotiviti. In this role, she is responsible for the oversight and strategic direction of Cotiviti’s FWA solution suite. Erin has been integral in the development of Cotiviti’s FWA solutions over the past eight years. Serving as the company’s primary subject matter expert in investigations and FWA for compliance, client training, sales and marketing activities, she regularly represents the company at industry conferences such as the National Health Care Anti-Fraud Association’s (NHCAA) Annual Training Conference (ATC)." />
AI can be a highly effective tool for plans aiming to reduce fraud, waste and abuse, but only if it is combined with investigative intelligence.
By being aware of the latest schemes, health plan leaders can ensure their members have appropriate access to care while preventing bad actors from exploiting telehealth policies established during the pandemic.
Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.