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
