Healthcare fraud : auditing and detection guide /

• Main Author: Busch, Rebecca S.
• Format: eBook
• Language: English
• Published: Hoboken, N.J. : John Wiley & Sons, [2012]
• Edition: 2nd ed.
• Subjects: 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.; Insurance crimes.; LAW > Criminal Law > General.; Medical care > Law and legislation > Criminal provisions.; Medical care / Law and legislation / United States / Criminal provisions.; United States.; Electronic books.

"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 Hea...

Table of 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.