This presentation by the Health 2.0 Conference talks about some basic yet rampant scams in the healthcare sector. This presentation also highlights the red flags to look out for, which sector is more susceptible to the scam and how IT can help eliminate it.

1. Scams In Healthcare:
Discussing Rising Concerns With the Health 2.0
Conference

2. 1. The Spectrum Of Healthcare
Scam
1. Sectors Most Susceptible To
Scam
1. What To Be Aware Of?
1. What Role Can IT Play In
Eliminating The Scam?
Contents

3. The Spectrum Of Healthcare Scam

4. Many healthcare events in the USA took the initiative and discussed the broadening spectrum
of healthcare scams and how patients are becoming victims of it time and again.
Let’s check the next slide to understand it better→

5. ● Although anybody in the system has the potential to conduct fraud, healthcare personnel perpetrate
health scams, waste, and abuse more frequently than patients do.
● Patients, employees, and individuals attempting to trick the healthcare system of funds are all
included in this.
● Organized crime, which is more dangerous but less frequent, includes counterfeiting and a recent
multi-million-pound electronic scam that affected many UK-based insurers and involved numerous
fictitious expatriate policies sending in fictitious medical bills.
● Anti-scam experts face a difficult challenge to remain ahead of the threat as fraud trends and
schemes continually evolve, develop, move, migrate, and morph.
● Some scams are incredibly clever, while others are remarkably ridiculous.
● Speed is crucial in many situations, such as those involving phantom suppliers.
● Before investigators can step in, the person who sets up a bogus storefront to make false claims will
make several claims, be paid for them, and then leave the premises.

6. Sectors Most Susceptible To Scam

7. A prominent healthcare conference held in Las Vegas namely the
Health 2.0 Conference talked about the scam and how some of
the healthcare sectors that appear to be showing the most
increase in susceptibility to it include:

8. ● Organized criminal organizations (which may use a variety of tactics but which appear to heavily rely
on medical identity theft or the stealing of patients' and providers' identities)
● Infusion treatment
● Treatment of pain (office-based opioid therapy)
● Drug and/or pharmaceutical diversion
● Sturdy medical supplies (involves significant medical identity theft)
● Centers for community mental health and behavioral health
● In-home medical care
● Cardiology
● Ophthalmology
● Transportation (ambulatory)

9. What To Be Aware Of?

10. ● Developing an anti-scam culture, which entails raising awareness and mobilizing the
honest majority, is one of the critical pillars of an anti-scam campaign.
● Healthcare professionals are thought to only work for the benefit of patients.
● The most significant barrier to solving the issue is simply raising awareness.
● After this, healthcare managers must ensure they have a solid program to evaluate risks,
reduce them, implement the necessary controls and checks, and have an agency or
enforcement regime to handle complex problems.

11. What Role Can IT Play In Eliminating The
Scam?

12. Several healthcare experts graced the healthcare event at Dubai- Health 2.0
Conference and imparted their wisdom on how introducing technology can be
helpful in combating the fight against scams:-

13. ● Before paying a scamming claim, it is more cost-effective to identify and stop fraud than
to look for the lost money later.
● A mature entity with the capacity to comprehend the issue, evaluate the results, and take
necessary action will benefit from analytics.
● We must not lose sight of the critical need for intelligent, perceptive, analytical, and
dedicated fraud-fighting specialists as we concentrate on the promise of technology.
● Fighting healthcare scam requires a multifaceted strategy that balances technological
and human resources.

14. Thank You!
This Presentation Is Prepared
By
Shivani Verma,
Manager, Health 2.0 Conference