Program
Presentations
Session 1 – Medical & Hospital Patient Care (Day 1)
01 – Conference opening & launch of PHA Fraud portal and Fraud awards (288 KB)
Hon Dr Michael Armitage, CEO Private Healthcare Australia
02 – Inpatient hospital and medical fraud in the U.S. and appropriate fraud prevention/minimisation solutions (2.57 MB)
Prof Malcolm Sparrow, Harvard University
03 – Medical fraud patterns and scope in Australia and its prevention (179 KB)
Dr Tony Webber, former Head of the Professional Services Review
04 – Operational approaches to hospital and medical leakage prevention (inc prostheses, chart to bill and coding audits, etc.) (2.96 MB)
Margaret Street, BUPA Australia
05 – Third party leakage and fraud/Compensation Recovery – things to consider to increase returns, pitfalls etc. (999 KB)
Paul Clarke, Managing Director National Health Recovery Agents
Session 2 – Ancillary Patient Care (Day 1)
06a – Ancillary panel on itemisation and appropriate servicing in Chiropractic (858 KB)
Luke Givney, HCF
06b – Ancillary panel on itemisation and appropriate servicing in Chiropractic (814 KB)
Dr Peter Werth, Chiropractice Advisor
06c – Ancillary panel on itemisation and appropriate servicing in Chiropractic (250 KB)
Dr Roger Engel, Macquarie University
07 – Dental Over Servicing and Fraud – an ADA perspective (2.40 MB)
Dr Stuart Gairns, CEO ADA, WA
08 – Fraud awareness for ancillary providers utilising e-learning (12.15 MB)
Wayne Mahmoud
Session 3 – Systems and Analytics (Day 2)
01a – Fraud patterns and fraud analytics for inpatient hospital and medical treatment in the U.S. (2.66 MB)
Ted Doyle (Vice President, Optimum Insight, United Health Care Group)
01b – Appendix: Fraud patterns and fraud analytics for inpatient hospital and medical treatment in the U.S. (3.10 MB)
Ted Doyle (Vice President, Optimum Insight, United Health Care Group)
02 – Regulating health practitioners in the national interest (402 KB)
Dominique Saunders, General Counsel at AHPRA
03 – Medical fraud patterns and medical compliance analysis in Australia (856 KB)
Mr Jeff Popple, Dep Secretary, Compliance Division, Human Services
04a – Analytic methods and tools for minimising Fraud and claims leakage (hospital, medical, prostheses, ancillary) (494 KB)
Luke Givney, HCF
04b – Analytic methods and tools for minimising Fraud and claims leakage (hospital, medical, prostheses, ancillary) (2.14 MB)
Michael Douman, BUPA Australia
04c – Analytic methods and tools for minimising Fraud and claims leakage (hospital, medical, prostheses, ancillary) (404 KB)
Keith Joyce, Medibank Private
Session 4 – Fraud Analysis and Investigation (Day 2)
05a – Staff and member fraud: Patterns and methods (319 KB)
Keith Joyce, Medibank Private
05b – Staff and member fraud: Patterns and methods (1.19 MB)
Michael Douman, BUPA Australia
06 – Fraud investigations (including mystery shopping) (206 KB)
Wayne Stone, HBF