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2005 Agenda
“Healthcare Fraud”
Two day advanced course by the Association of Certified Fraud Examiners. Las Vegas NV, December 12th and 13th 2005 www.cfenet.com
Commission Title: “Achieve synergy through coordinated efforts by applying a global perspective to effectively identify, detect, and prevent health care fraud.”
Austin, TX, August 23, 2005 www.hhsc.state.tx.us
“New Organized Healthcare Fraud Schemes: How to protect your organization”
White-Collar Crime Fighter
July 2005 page 5. VOLUME 7 NO. 7
“Evaluating Health Care Benefit Risks”
2005 Institute of Internal Auditors (IIA) International Conference, Hyatt Regency Chicago Hotel, Chicago, IL July 12, 2005 www.theiia.org
“Health Care Fraud Update”
2005 16th Annual Fraud Conference & Exhibition, Hilton,
Washington, DC July 11, 2005 www.cfenet.com
“How to Avoid Private Payer Fraud Investigations … and Improve Your Billing”
Private Payer News Audio Conference,
June 21, 2005 www.decisionhealth.com
“Healthcare Fraud”
Two day advanced course by the Association of Certified Fraud Examiners. Chicago, IL May 5 & 6, 2005 www.cfenet.com
“Providers and the Reality of Health Care Today”
The NHCAA Institute for Health Care Fraud Prevention Conference: Behind the scenes: what criminal providers and billing consultants do to defeat anti-fraud efforts. March 23, 2005 Sheraton Atlanta Hotel, Atlanta, GA.
www.nhcaa-institute.org
“Healthcare Fraud”
Two day advanced course by the Association of Certified Fraud Examiners. Charlotte, NC March 22 & 23 2005 www.cfenet.com
“Internal Audit Perspective: How do fraudsters target cash rich dollars in employee health benefit programs?”
Program presented by the Institute of Internal Auditors (www.theiia.org) and The Association of Certified Fraud Examiners (www.cfenet.com);
January 10, 2005; Holiday Inn, Cleveland, Ohio.
1999-2004 Presentations
“PHI Audits: The Global use of protected health information in organized crime, is your
organization ready?”
The 14th Congress of International Federation of Health Records Organizations in conjunction with the AHIMA 76th National Convention and Exhibit, October 12, 2004 Washington, DC, USA www.ahima.org
“Data Mining & Denial Management”
American Association of HealthCare Administrative Management, September 16, 2004 Bloomington, Illinois, September 16, 2004 www.ilaaham.com www.aaham.com
“Auditing employer benefit plans for fraud schemes.”
The Annual Fraud and Ethics Conference for the Institute of Internal Auditors, Chicago, IL August 3, 2004 www.theiia.org
“Avoiding the Pitfalls of Protected Health Information and Fraud"
15th Annual Fraud Conference and Exhibition: Assn. Of Certified Fraud Examiners, July 12 – 14, 2004, Las Vegas, NV www.cfenet.com
“New Emerging Strategies by the Ethically
Challenged to tap into your Health Plan Benefit $'s- Are You Ready?”
Health Care Fraud Prevention and Funds Recovery Summit, June 21 - 23, 2004 Washington, DC June 23, 2004 www.worldrg.com
“The Role of Integrated Technology in Homeland Security”
American College of Forensic Examiners International: 2004 Homeland Security Conference, Arlington, VA May 20, 2004 www.acfei.com
“Analytic & Data Mining Techniques”
Midwestern Intergovernmental Audit Forum: Auditing in the Millennium, Chicago, Illinois March 13 - 14, 2004 www.auditforum.org www.ci.chi.il.us
“Advanced Practice Issues in Health Care Forensics: Application of Research, Data Mining and Investigation Techniques in new emerging fraud schemes.”
American Association of Legal Nurse Consultants, March 31, 2004 Chicago www.aalnc.org
“PHI Technology Audits: How to Leverage Emerging Technology to Combat Health Care Fraud and Abuse through Protected Health Information Audits.”
Institute International of Research, Las Vegas, January 28, 2004 - January 30, 2004 www.iirusa.com
"RED FLAGS California medical providers dramatically over billed insurers for services rendered”
Interview with Paul Rubin,
January 4, 2004 www.pheonixnewtimes.com
“Empowering Patients to Direct Their Health Care”
American Association of Case Managers; November/December 2003 Issue www.cmsa.org Mosby Pub.
"California's rent-a-patient scam has reaped millions for greedy physicians, clinics and patients”
Interview with Paul Rubin, December 18, 2003 www.pheonixnewtimes.com
“Health-Care Fraud Prevention: Safeguarding Information is Key to Success”
White Collar Crime Fighter, October 2003 Issue www.wccfighter.com
“Practice Development & Market Opportunity: How to improve your practice margins and revenue streams through operational audits and market evaluations.”
Union League Club - Chicago, Illinois October 24, 2003 www.chicagoreviewcourse.com
“Health Care Portfolio: Tools for Employers and Employee in preventing Fraud and Abuse, & Medical and Financial Errors”
The Assurance Agency, Deerfield IL August 12, 2003
“Insurance Vendor Fraud Audits- How to Detect
Health Care Fraud"
14th Annual Fraud Conference and Exhibition: Assn. of Certified Fraud Examiners, August 2003, Chicago, IL www.cfenet.com
“Making a Big Impact with Employer Benefit Audits”
Institute of Internal Auditors: International Annual Conference, June 23, 2003 Las Vegas, NV www.theiia.org
“Panel Member: long term care,
reimbursement, privacy issues”
“Life Care Planning: How they impact your
business operations”
Health Financial Management Association Continuum of Care Conference: Post Acute Care Issues. April 17, 2003 Oak Brook IL www.hfma.org
“Case Study: Financial Analysis of the Life Care Plan”
Mosby Conference, Las Vegas, Nevada, March 28, 2003. Advanced Practice Case Management Conference http://www.us.elsevierhealth.com
“HIPAA 2003 Wake Up Call Security Alert and Operational Management of Privacy Provisions”
Chicago, IL February 27, 2003 Sponsored by Cisco Systems, Freeborn & Peters, Remington Associates, LTD Chicago Athletic Association
Crain's Chicago Business
Interview with Crain's regarding Health Care Employer Audit Programs
in an article called “Health Plan Audits Stem Costs” by Lisa Bertagnoli http://www.chicagobusiness.com 2/3/03
“Financial Diagnostic Tools and Comprehensive Life Care Planning”
Journal of Life Care Planning; December 2002 Issue. International Academy of Life Care Planners www.interanationalacademyoflifecareplanners.com
“Cost Methodology: Streamlining Your Life Care Plan.”
University of Florida, Intellicus, 7th Annual Life Care Planning Conference. October 2002. Reno, Nevada.
“Avoid the Deadly Traps in Managing Health Care Information”
White Collar Crime Fighter. August 2002 Issue. www.wccfighter.com
“The Effects of Privacy Regulations on Health Care Fraud Investigations & Audits”
13th Annual Fraud Conference & Trade Show,
Hollywood CA. August 2002.
“Overview on how to identify exposure to loss in administering their health insurance plans, discussion on financial errors, medical errors, and liability of health information privacy exposure, and operational issues in administering benefits including Family Care & Medical Leave.”
ASBO (Association of School Business Professionals) Annual School Board Spring Conferences- Risk Management,
St. Charles, IL April 2002.
"Red Flags every self insured employer should recognize” “Key elements in structuring health care benefit audit”
The Institute of Internal Auditors, March 2002 Chicago, IL
“Quality Data Issues and its Adverse Impact on Research Methodology”
International Association of Life Care Planners, Academy Newsletter, fourth quarter 2001.
“Life Care Plan: A Methodological and Scientific Approach”
International Association of Life Care Planners, Academy Newsletter,
third quarter 2001.
“Risk Assessment, Implementation Strategies on Health Care Privacy Issues”
HIPAA SUMMIT WEST, 2001 San Francisco, CA
“Health Care Finance/Budgeting”
“Critical Thinking and Strategic Problem Solving”
University of Illinois, Chicago, 2001
“Determining Fraud In Workers Compensation Cases”
CPAmerica International Newsletter, 2001
“Understanding Physician Valuation”
Heath Care Informatics eMD Expo and Conference, 2000
“Health Care Fraud and the Medical Record” “Understanding the Legal Process”
American Association of Legal Nurse Consultants,
Chicago, Illinois 2000, 1997
“The Financial Case Manager: Increased Revenue Captured at the Bedside”
MBA Newsletter, Oak Brook, Illinois, 1998
“Medical Record Documentation with respect
to HCFA guidelines”
Humana: Florida Region, 1997
“Medical Record Documentation with respect
to HCFA guidelines”
Humana: Chicago Region, 1997
“Health Care Reimbursement, Medical Record Documentation”
Chicago Bar Association, 1996
“Negotiating an Effective DRG Commercial Contract”
Health Care Financial Management Association (HFMA) National Convention, Washington D.C., 1995
“How to respond to requests for discounted payments and payment denials...(written and telephone skills)” “Financial implications of medical record documentation”
Children's Memorial Hospital, Chicago, Illinois, 1995
“The Financial, Clinical and Legal Impact of Medical Record Documentation”
Suburban Hospital,
Hinsdale, Illinois, 1994
“The Financial, Clinical and Legal Impact of Medical Record Documentation”
LaGrange Memorial Hospital,
LaGrange, Illinois, 1993-1995
“Commercial DRG Contracting”
HFMA Magazine, First Illinois Speaks November'93
“DRG's, Coding, and Hospital Reimbursement”
Chicago Metropolitan Health Care Council, Chicago, Illinois, 1992
“Provider Charge Integrity Program”
Health Care Financial Network (HFN, Inc), Chicago, Illinois, 1991
“DRG's in the Commercial Payer Environment”
College of DuPage, Glen Ellyn, Illinois, 1990
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