Enhance Your SIU Capabilities

What is SIU and its Importance?

Special Investigation Units (SIUs) are the frontline defenders of healthcare plans’ program integrity. SIUs play a crucial role in identifying, investigating, and resolving instances of potential fraud, waste, and abuse. Beyond investigation, SIUs ensure compliance with regulatory requirements and collaborate with other program integrity components to detect and address potential issues in policy applications, enrollment, and claims processing.

While the healthcare industry aims to process claims accurately and automate error correction, the human element remains indispensable. Investigators and Medical Record Reviewers interpret data, using their expertise in fraud, waste, and abuse (FWA) to assess its impact on the plan and take appropriate corrective actions. Despite advancements in algorithms, flags, and edits, experienced professionals are essential for effective data interpretation and resolution.

What Sets Us Apart? 

  • Experienced Trainers: Our team comprises OIG trainers with extensive law enforcement (LEO) experience and a solid background in training.


  • Commercial Collaboration: Our trainers have been working with commercial health plans for years, providing valuable insights and expertise.

     

  • Bridging the Gap: We adeptly bridge the gap between traditional law enforcement healthcare fraud investigations and Managed Care Organization (MCO) SIU investigations or audits.

     

  • Deep Understanding: We possess a deep understanding of SIU priorities, processes, and policies, allowing us to tailor our training to address specific client needs.

     

  • Client-Focused Training: By gaining insights into specific needs, we focus our training on the most beneficial areas for our clients.

Curriculum:

  • Customized Training: Our training program can be tailored to meet the specific needs of your staff.

     

  • Flexible Delivery: We offer both in-person and virtual (or mixed) training sessions to accommodate different preferences and schedules.

     

  • Interactive Learning: Training sessions include interactive role-playing and mock case investigations to enhance practical skills.

     

  • Focused Content: The training can concentrate on:

    • Specific areas of fraud
    • Investigative techniques
    • Case management
    • Documentation
    • Creation of quality referral packages
    • Or a combination of topics as required.

  • Broad Experience: Our trainers’ extensive experience ensures we understand the needs of end users, such as MFCUs, federal prosecutors, or state agencies.

     

  • Relevant and Impactful: We deliver highly relevant and impactful training by focusing on what is most beneficial for fraud referrals.

Ready to Enhance Your SIU Capabilities?

Partner with us to equip your team with the skills and knowledge needed to combat fraud, waste, and abuse effectively. Our tailored training programs and experienced trainers ensure your staff is prepared to handle any challenge.

Contact Us Today to Learn More and Schedule Your Training Session!

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