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Skye Schmeitz

The Koyal Group Training: Social Media, a Trove of Clues and Confessions - 4 views

Source: http://www.nytimes.com/2014/02/16/sunday-review/social-media-a-trove-of-clues-and-confessions.html?hpw&rref=opinion&_r=0 IT seems as if every week there's a news story about someone commit...

Private Training at Koyal Group Social Media a Trove of Clues and Confessions

started by Skye Schmeitz on 21 Feb 14 no follow-up yet
Daniel Schweizer

The Koyal Group Private Training Services: Tips and Tools for Insurance Fraud Investiga... - 1 views

Technology and social media are great tools used to investigate insurance fraud, according to expert panelists who spoke at the recent Risk and Insurance Management Society conference in Denver. S...

The Koyal Group Private Training Services: Tips and Tools for Insurance Fraud Investigations

started by Daniel Schweizer on 26 Jun 14 no follow-up yet
Skye Schmeitz

The Koyal Training Group: Insurance Fraud Investigator Training and Degree Program Info... - 0 views

There are not set education standards for becoming an insurance fraud investigator. Some available options to potential insurance fraud investigators include a certificate program in private invest...

The Koyal Training Group Insurance Fraud Investigator and Degree Program Information

started by Skye Schmeitz on 13 Feb 14 no follow-up yet
Dirk Braun

Koyal Group Training Services: My Biz: Making private investigation a family business - 1 views

Hunting down a witness, catching a cheating spouse, finding out if someone is really injured - Jeff Marlin of Marlin's Special Investigation doesn't have a typical job. Marlin's father, Mike Marl...

Koyal Group Training Services My Biz: Making private investigation a family business

started by Dirk Braun on 09 Apr 14 no follow-up yet
Dirk Braun

Koyal Group Training Services, Big risks and big data - 1 views

Imagine now, that ocean as the vast body of data and information that flows through the average company in a given year. Sales, collections, purchases, payments, transactions, communications, e-mai...

Koyal Group Training Services risks and big data

started by Dirk Braun on 07 Apr 14 no follow-up yet
Skye Schmeitz

Congress focusing on significant changes to federal security-clearance process - 3 views

Source: http://www.washingtonpost.com/politics/federal_government/congress-focusing-on-significant-changes-to-federal-security-clearance-process/2014/02/16/15c58f1c-94ff-11e3-83b9-1f024193bb84_stor...

Private Training at Koyal Group Congress focusing on significant changes to federal security-clearance process

started by Skye Schmeitz on 18 Feb 14 no follow-up yet
Doreen Wolf liked it
Daniel Schweizer

The Koyal Group Private Training Services on Fraud investigation tips from Deloitte's M... - 1 views

www.fiercehealthpayer.com/...2014-06-24

The Koyal Group Private Training Services Fraud investigation tips Deloitte's Mike Little

shared by Daniel Schweizer on 30 Jun 14 - No Cached
  • Daniel Schweizer on 30 Jun 14
     
    FierceHealthPayer: Anti-Fraud: What are some early indicators SIUs can watch for signaling that reports of potential fraud, waste and abuse may become significant or urgent cases? Mike Little: Assessing allegations early is a challenge, but taking some specific and general steps can help SIUs determine if a case may become a priority. The first specific step is assessing the allegation. What's involved, and what's the scope of the issue? Could it be part of a larger problem or national scheme with the potential for media attention? Also check if patient safety is at risk. Financial harm at the expense of patients is an area that becomes urgent very quickly. And different case steps are necessary if patient safety issues are involved as opposed to financial issues alone. Are there signs that unlicensed individuals are at work? This can raise questions about your company's credentialing and due diligence processes that affect patient safety. And lastly, determine if employees from your organization may be implicated. That may cause reputational harm and indicate internal control weaknesses. But insurers and the federal government can no longer wait for complaints to arrive because often by then there's been significant loss. So SIUs should also take general steps to spot trends and risks. These steps involve knowledge. First, plug into a healthcare fraud task force. These exist nationwide and include other SIUs and federal and state law enforcers and regulators. These groups are the wave of the future in terms of public and private partnerships. There's a great deal of information shared about what's happening at other companies or in other segments of the community.
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