Kick-start your week by attending one of our focused workshops. Industry professionals will give an in-depth discussion on the topic at hand. These optional workshops will include hands-on learning and group activities. This is a great opportunity to share your knowledge and network with peers. Workshops will be held on Monday, June 8th.
Workshops are available for an additional fee of $195
Open Source Intelligence (Bring Your Own Device)
The way people choose to communicate and the tools that facilitate that communication is evolving rapidly. This presentation provides you with information on how to better find and secure results from online sources and social media platforms. We will discuss the recent changes with Facebook, Instagram, and Twitter and what third party sites you can use to pull hidden data and help develop leads. You will delve into mobile data, location services, and mobile apps like TikTok, Google Hangouts, and Twitch. Learn different exploits to help you locate people with mobile systems and understand how URL structures can help you locate profiles much quicker. We will also discuss using non-traditional means like source code and the inspect element, how to analyze the information once you've found it, and will review browser extensions & add-ons that every investigator should have on their computer. Just as important as locating the information, this talk will discuss how investigators can protect themselves (and their families) during online investigations. In the end, the attendees will walk away with a wide range of resources and tools needed to find, collect, and examine open source intelligence.
Medical Mills & Provider Fraud
This course examines the medical mill structure, the daily office processes, the mill feeding mechanisms, and the money laundering schemes. We will review the clinic inspection and advanced interviewing topics specific to the onsite visit. Special emphasis will be placed on understanding the details of clinic structure, billing (CPT & ICD 9 & 10), Diagnostic testing, treatment plans, medical records, physical exams and the investigative skills necessary to evaluate or prepare a prosecutable case.
Medical Billing Fraud
Medical billing fraud takes on many forms. Those who commit it are highly adaptive and frequently change tactics to avoid detection. Claims adjusters and SIU investigators are key to identifying medical billing fraud and abuse. This unique course examines medical billing fraud from the perspective of the investigator, medical expert, and data analyst. We begin with a brief overview of CPT codes, ICD-10, and medical billing forms followed by a discussion of the billing process. Using case examples, we will explain some of the most common types of billing fraud, and then take a closer look at recent trends involving diagnostic testing, injections, trauma activation, and physical medicine, including acupuncture and chiropractic. At the end of this course students will be able to identify questionable billing, determine exposure, gather and analyse relevant information, and develop action plans for mitigating losses and future exposure.
The Future of Vehicle Theft
This session will take a deep dive in to vehicle theft, breaking down in to five sections. Attendees will learn how to identify stolen/altered motor vehicles by reviewing the basic principles of vehicle identification and common methods used for VIN switched vehicles. Instructors will discuss the current technologies used for the development and implementation of digital drivers’ licenses and vehicle registrations. Learn about keyless vehicle ignition systems and discuss how they are being defeated to commit theft. Attendees will hear about the modern-day methods used to steal vehicles through fraudulent identities, stolen identities, and synthetic identities. This session will also cover the nomenclature of heavy equipment and basic principles of heavy equipment identification. Join your peers to gain knowledge on how to combat vehicle theft.
Investigation and Prosecution Skills
This one-day skills workshop will teach you everything you need to know about the investigation and prosecution of an insurance fraud case. Part One will focus on the investigation stage – starting with the first phone call from the insured. Desk Investigations, interview techniques, report writing, and strategic considerations will be covered in this section. We will also cover information storage and documentation, as well as the exchange of that information with the criminal investigators and prosecutors. Part Two prepares you for court – discovery issues, communication with lawyers, and what to expect from witness testimony and trial. In both parts, members will have an opportunity to break out into small groups to work through common issues that arise in fraud investigations and prosecutions. There will also be a mock trial where presenters will demonstrate direct and cross-examinations of both law enforcement and member company witnesses, with tips on how to prepare for courtroom testimony.