National Health Care Anti-Fraud Association (NHCAA) Annual Training Conference 2022

National Health Care Anti-Fraud Association (NHCAA) Annual Training Conference 2022

About the Event

The NHCAA estimates that financial losses due to health care fraud are in the tens of billions of dollars each year. A conservative estimate is 3% of total health care expenditures, while some government agencies place the loss as high as 10% of our annual health outlay, which could mean more than $300 billion. The NHCAA Annual Training Conference is recognized as the single-most important health care anti-fraud event, spotlighting trends and emerging schemes. MedReview will be a Platinum Sponsor at this year’s in-person event, and our team looks forward to seeing you there!

See Agenda for Daily Details

MedReview Attendees:

  • Spencer Young, MD, Chief Executive Officer
  • Ted Pitynski, V.P. Growth & Strategy
  • Lorenzo Jackson, Sales Account Director

DRGs: Historical Review, Current Upcoding, and Future Technology Advancements

Wednesday, November 16 | 1:45 PM EST

Presented by MedReview

This presentation explores the history of the DRG system, the refinements made over time, and how those refinements are being abused to game the system. The speakers will also breakdown how the latest technology is changing modern payment integrity to combat this type of fraud, waste, and abuse. The speakers will explore news stories with egregious examples of upcoding and review individual cases within their own book of business to highlight cases physician reviewers have found. Building upon workflow automation, MedReview’s technology includes AI, natural language processing (NLP) and machine-learning (ML). MedReview uses NLP to ingest medical records and scan these records for keywords that will, tell the machine-learning piece of the algorithm what data to look for and the supporting clinical values. While many payment integrity firms have moved away from clinical validation using a physician, the speakers will illustrate why they believe it’s time to double down on clinical validation.
Speakers: 
• Michael Menen, MD, Chief Medical Officer, MedReview Inc.
• Spencer Young, Chief Executive Officer, MedReview Inc.

Event Details:

November 15–18, 2022

7:00 a.m. – 5:00 p.m.

Booth #327

Orlando, Florida

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