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    Telehealth Fraud

    ​​Good Morning Everyone! With the relaxed restrictions surrounding telehealth as a result of COVID-19, curious how other health plans are developing internal processes/procedures on monitoring FWA for both medical and Part D?  Thanks! ------------------------------ ...

  • Hi there! I don't have any answers but am curious to know as well!  We are a very small company and have been doing almost everything so far manually.  I think we need to transition to some more automated systems for parts of the process.  So I will be ...

  • Hi Compliance Community, I'm curious to know about some of the most common software platforms that you use in your profession? Do you use statistical software such as SAS or R? Or is that all taken care of by the analytics department and they simply ...

  • Hello all, May I have your thoughts and practices regarding peer review results and compliance? I've searched the historical messages and did not see this specific topic.   If there is action taken in peer review, how do you/your organization ensure that ...

  • ​​Hello All:  First, I hope you and yours are faring well during this trying time. I perform various compliance audits and due to Covid-19 am having difficulty (primarily due to limited staff) accessing the data I need to allow me to complete these ...