WellPoint's John Steffy: How to use social media to detect healthcare fraud
Investigators have to be careful with the use of data mining tools because they're built to return data. There's a distinction between data and intelligence.
Data have to be refined and sorted and sifted before you can consider them useful intelligence. When investigators manually review social media, they can give themselves a head start on the intelligence cycle by gathering data and sorting out the relevant bits of intelligence in one condensed step.
Data mining tools are often available from the same vendors that sell other investigative tools. But many social media data mining tools are meant to assist marketing teams.
Investigators also have to be careful when deciding which tools to use. There are obviously security concerns with placing any kind of software on a corporate or government computer or asset for investigative purposes. With pitfalls like that, manual review of social media is really the safest course to follow.
FHP:AF: Does social media information have a use in commercial and government business fraud investigations?
Steffy: Investigators can--at the very least--use social media intelligence to augment or corroborate what they already know or evidence they've gained from other sources.
Further, investigators can use social media to build their knowledge of a profession or specialist. Let's say you know how an oncology practice works but want to learn more. Oncology practices will often post YouTube videos that detail the intricacies of how the profession functions.
Investigators should also be mindful of social media sites geared towards reviewing services provided by a profession. Yelp is very helpful here. You can use it to data mine for witnesses or glean information from online complaints you may not otherwise have known about.
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