Greg Hunter, Director of Provider Audits for Neighborhood Health Plans

Greg Hunter has eleven-plus years of experience in the industry working for health insurers as well as entities providing services for payer organizations. He joined Neighborhood Health Plan (NHP) in 2003, where he is responsible for key initiatives addressing claims overpayments and recoveries, including third-party liability, hospital bill auditing and fraud and abuse investigations. Hunter has been a Certified Professional Coder since 2003 and received an Accredited Health Care Fraud Investigator (AHFI) designation in 2010. He has delivered presentations on cost containment at conferences across the country.

One of the most rewarding investigations he’s worked on and which has yielded the highest return, has been the urine drug testing investigation which recovered millions of dollars. Greg’s efforts uncovered the network responsible for the largest questionable drug testing scheme in the nation and aided in their recent arrest and charge of Medicaid fraud. Greg states,”NHP auditors were able to tease out a network of over 30 physicians working out of 26 sites with multiple pay-to NPI’s using Intelligent Investigator™. It would have been difficult for NHP’s auditors to identify the full scope of the scheme if we had to wait for queries to come back from IT.”

Greg has been an active participant at our yearly User Group Conferences. He has recommended several key suggestions that we have adopted into the system and provided to our customers.

EDIWatch would like to thank Greg for his loyalty and support.