By Rebecca S. Busch
ISBN-10: 0470127104
ISBN-13: 9780470127100
ISBN-10: 0470227087
ISBN-13: 9780470227084
In response to deepest and public estimates, nearly $24 million is misplaced consistent with hour to healthcare waste, fraud, and abuse. a must have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud: Auditing and Detection advisor offers information and strategies that will help you spot—and prevent—the "red flags" of fraudulent job inside your company. Eminently readable, it's your “go-to” source, equipping you with the mandatory talents to seem for and take care of capability fraudulent events.
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Extra resources for Healthcare Fraud: Auditing and Detection Guide
Example text
Recognize the reality of risks and limits of the science of medical care and the human fallibility of the healthcare professional. Be aware of a healthcare provider’s obligation to be reasonably efficient and equitable in providing care to other patients and the community. Become knowledgeable about his or her health plan coverage and health plan options (when available) including all covered benefits, limitations, and exclusions, rules regarding use of network providers, coverage and referral rules, appropriate processes to secure additional information, and the process to appeal coverage decisions.
Podiatry is the art and medical science of treating the lower extremity with a focus on the foot and ankle. The professional care of feet 30 chapter 2 defining market players dates back to the Egyptians with carvings designating the art in the care of the feet. Hippocrates in his writing noted the treatment regimen for calluses and corns of the feet. Dentists receive a Doctor of Dental Surgery (DDS) degree or Doctor of Dental Medicine (DMD) degree. Dentistry is the art and science of prevention, diagnosis, and treatment of conditions, diseases, and disorders of the oral cavity, the maxillofacial region, and its associated structures as it relates to human beings.
This criminal statute applies to any federal government department or agency. The making of fraudulent claims is a felony, and the 1986 amendments to the FCA mandate both a fine and imprisonment for all convictions. In addition to bringing a criminal action, the government may also bring a parallel civil action seeking relief. The FCA affords the private citizen new incentives to report suspected frauds. It also gives whistleblowers extensive protection from harassment and retaliation from employers.