ISSA Webinar: Detecting fraud in health care through emerging technologies

19 January 2022 | Virtual

ISSA Webinar: Detecting fraud in health care through emerging technologies

19 January 2022 | Virtual

Wednesday, 19 January 2022, 10:00−11:30 (UTC/GMT+1 or CET)

Languages: Simultaneous interpretation in English, French and Spanish
(Simultaneous interpretation
 – Frequently Asked Questions)

The health care industry is adopting technologies at a fast pace and at the same time health care and medical insurance are increasingly vulnerable to fraud, which is by nature hidden and therefore difficult to assess. The identified amounts of health care fraud increase each year and traditional fraud detection efforts are unable to cope with the rapidly increasing health care utilisation and costs. As investigators cannot manually monitor transactions and crimes in real time, fraudsters are long gone by the time the fraud is detected.

However, nowadays, fraud detection and prevention technology has made enormous strides from advances in computing, analytics, machine learning and other forms of artificial intelligence (AI), reducing detection time and giving the ability to create faster more advanced and accurate analytics.

Whilst social security institutions constantly aim for the optimization of processes with the help of advanced analytics and AI − bringing opportunities to detect and monitor fraud more effectively and efficiently, opening up endless possibilities − adopting such emerging technologies poses important challenges.

Join us for this webinar, in which the European Healthcare Fraud and Corruption Network (EHFCN) and ISSA members will discuss how emerging technologies are being used to respond to the rapidly changing health care environment to better detect, monitor and tackle fraud in health care.

Speakers

Ali Ghufron Mukti Ali Ghufron Mukti, President Director, Social Security Administering Body for the Health Sector (BPJS Kesehatan), Indonesia and Chair of the ISSA Technical Commission on Medical Care and Sickness Insurance
Tom Verdonck Tom Verdonck, President, European Healthcare Fraud and Corruption Network (EHFCN)
Sang-Baek Chris Kang Sang-Baek Chris Kang, Director General, Department of Global Cooperation, National Health Insurance Service (NHIS), Republic of Korea

This webinar will examine the following questions:

  • Which innovative tools and techniques developed to detect and monitor fraud in health care have proven to be effective and efficient?
  • What have been the major challenges to develop and apply these tools and techniques in the health care sector?
  • Fraud does not stop at borders: How can data-driven approaches be applied in a cross-border context, in view of the international collaboration?
  • What is next, considering the emerging medical services and the lessons learned from the pandemic?

Agenda

  • Welcome by Marcelo Abi-Ramia Caetano, ISSA Secretary General
  • Introduction by the chair of the ISSA Technical Commission on Medical Care and Sickness Insurance
  • Keynote from EHFCN: AI in countering fraud and waste in health care and the implementation of AI in national legislation
  • Case experience from Indonesia
  • Case experience from Republic of Korea
  • Q&A – Discussion
  • Conclusions
Raúl Ruggia-Frick Moderated by Raúl Ruggia-Frick, Director, Social Security Development Branch, ISSA

Practical information

The webinar is open to delegates of ISSA member organisations and invited institutions without registration fee.