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Healthcare fraud : auditing and detection guide / [electronic resource]

by Busch, Rebecca S.
Material type: materialTypeLabelBookPublisher: Hoboken, N.J. : John Wiley & Sons, ©2012Edition: 2nd ed.Description: 1 online resource.ISBN: 9781118227220; 1118227220; 9781118240250; 1118240251; 9781118264959; 1118264959; 9781119203636; 1119203635.Subject(s): Medicare fraud | Medicaid fraud | Medical care -- Law and legislation -- United States -- Criminal provisions | Financial Audit -- methods | Fraud -- prevention & control | Computer Security | Fraud -- economics | Health Care Sector -- legislation & jurisprudence | Medicare fraud | Medicaid fraud | Medical care -- Law and legislation -- United States -- Criminal provisions | Insurance crimes | LAW -- Criminal Law -- General | Medicaid fraud | Medical care -- Law and legislation -- Criminal provisions | Medicare fraud | Medicare fraud | Medicaid fraud | Medical care / Law and legislation / United States / Criminal provisions | Insurance crimes | United States | Electronic booksOnline resources: Wiley Online Library
Contents:
Healthcare Fraud; Contents; Preface; Acknowledgments; CHAPTER 1 Introduction to Healthcare Fraud; What Is Healthcare Fraud?; Healthcare Fraud in the United States; Healthcare Fraud in International Markets; What Does Healthcare Fraud Look Like?; Who Commits Healthcare Fraud?; What Is Healthcare Fraud Examination?; The Primary Healthcare Continuum: An Overview; Healthcare Fraud Overview: Implications for Prevention, Detection, and Investigation; Notes; CHAPTER 2 Defining Market Players within the Primary Healthcare Continuum; The Patient; The Provider; The Payer; The Employer/Plan Sponsor.
Summary: "This second edition provides comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans. New chapters have been added covering a comprehensive auditing model developed by the author on all of the key elements that must be addressed: Primary Healthcare, Secondary Healthcare, Information/Data Management and Privacy, Damages/Risk Management, and transparency. In addition to six new chapters, the current edition material will all be updated and brought up to date"--Provided by publisher.
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Includes bibliographical references and index.

Healthcare Fraud; Contents; Preface; Acknowledgments; CHAPTER 1 Introduction to Healthcare Fraud; What Is Healthcare Fraud?; Healthcare Fraud in the United States; Healthcare Fraud in International Markets; What Does Healthcare Fraud Look Like?; Who Commits Healthcare Fraud?; What Is Healthcare Fraud Examination?; The Primary Healthcare Continuum: An Overview; Healthcare Fraud Overview: Implications for Prevention, Detection, and Investigation; Notes; CHAPTER 2 Defining Market Players within the Primary Healthcare Continuum; The Patient; The Provider; The Payer; The Employer/Plan Sponsor.

"This second edition provides comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans. New chapters have been added covering a comprehensive auditing model developed by the author on all of the key elements that must be addressed: Primary Healthcare, Secondary Healthcare, Information/Data Management and Privacy, Damages/Risk Management, and transparency. In addition to six new chapters, the current edition material will all be updated and brought up to date"--Provided by publisher.

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Last Updated on September 15, 2019
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