Investigation ToolBox
Investigation Toolbox
The sharing of information regarding emerging fraud schemes and suspected fraudulent providers between private plans and our government liaison partners or government agencies is a top priority for NHCAA. In order to maintain its position as the number one resource for anti-fraud initiatives, NHCAA consistently reviews and enhances its suite of fraud fighting tools to increase member benefits.
SIRIS®
SIRIS® is a searchable database that consists of three data sets: one devoted to provider cases; another for health care fraud schemes; and a third that administers Requests for Investigation Assistance (RIAs) from our law enforcement partners.
Request for Investigation Assistance
RIA provides our Government Liaison agencies the ability to reach scores of private health insurers in one simple step for assistance in their health care fraud investigations.
Information-Sharing Conference Calls
NHCAA offers Information-Sharing Conference Calls on a monthly basis via a secure platform for our Member Organizations and Government Liaisons.
Case Discussion Roundtable Meetings
The sharing of case information is one of the cornerstones of NHCAA. Case Discussion Roundtable Meetings provide an opportunity for both our private and public sector members.
Fraud Briefs
NHCAA Fraud Briefs are summaries that describe a scheme related to a specific health care service. These summaries can also be used when executive management needs a better understanding of the issue.
The Sentinel
The Sentinel is a monthly newsletter that provides members with Anti-Fraud Initiatives’ updates on information-sharing opportunities and resources.
Inside SIRIS®
Inside SIRIS® provides monthly SIRIS® updates specifically designed as a resource for our Member Organizations and Government Liaisons (GLs) to increase their fraud fighting success.
The Compass
The Compass is a quarterly health care fraud report. It contains intelligence gathered from NHCAA’s Government Liaisons and Member Organization’s
