2015 Annual Training Conference & Anti-Fraud Expo
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Dental Fraud Schemes in the Commercial & Public Sector
(
Room
Balboa ABC
)
19 Nov 15
8:15 AM
-
9:30 AM
Tracks:
Detecting and Investigating Dental Fraud
Speaker(s):
Richard Celko, DMD, MBA, AHFI, Regional Dental Director, UPMC Health Plan;
Stewart Balikov, DDS, AHFI, National Dental Director Utilization Management, Aetna Inc.
Dental fraud, waste and abuse schemes in both the commercial and public sectors appear with many similarities, however investigators need to be aware of the differences in plan design in order to better detect schemes which are predominantly focused to each unique sector. This presentation will review the more common schemes in dental fraud and discuss how they would appear to the investigator in the commercial and public sectors, and what particular investigative skills may be required as seen through the experiences of both commercial and government sector dental directors.
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