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Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.

[PDF] Healthcare Fraud: Auditing and Detection Guide - Semantic Scholar

Her entrepreneurial, professional, driven career has resulted in various proprietary audit platforms in multi-market verticals in healthcare, and authorship of over articles, books, and presentations to consumers, government, corporate, and professional entities. Recognized as an expert in her field, she has provided public and forensic expert testimony and participated in public policy discussions and the development of best practice standards.

Rebecca currently has seven U. S patent focused on efficacy, risk, FWB, and revenue management within healthcare.

Auditing and Detection Guide

Account Options Mag-sign in. According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are.

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Healthcare Fraud: Auditing & Detection Guide

Chapter 1. Introduction To Healthcare Fraud. What Is Healthcare Fraud? Healthcare Fraud in the United States. Healthcare Fraud in International Markets. Who Commits Healthcare Fraud? What Is Healthcare Fraud Examination? The Healthcare Continuum: An Overview. Chapter 2.


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  5. Healthcare Fraud: Auditing and Detection Guide, 2nd Edition [Book].
  6. Advances in Cryptology: Proceedings of EUROCRYPT 84 A Workshop on the Theory and Application of Cryptographic Techniques Paris, France, April 9– 11, 1984.

The Patient. Who Is the Patient? The Provider. Who Is the Provider? The Payer. Who Is the Payer? The Vendor and the Supplier. Who Are the Vendor and the Supplier? The Government.

Busch, Rebecca S.

Who Is the Government? Organized Crime.

Who Is Organized Crime? Chapter 3. Protected Health Information. Health Insurance Portability and Accountability Act of Chapter 4. Health Information Pipelines.


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  • Recent trends in information reuse and integration.
  • The Auditor's Checklist. The Government Plan Sponsor. Unauthorized Parties. Accounts Receivable Pipelines.

    here Overview of Healthcare Reimbursement. Types of Reimbursement Models.


    1. Healthcare Fraud: Auditing and Detection Guide.
    2. Healthcare Fraud: Auditing and Detection Guide!
    3. Noncommutative geometry in M-theory and conformal field theory;
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    5. Healthcare Fraud: Auditing and Detection Guide?

    Fee for Service Model. Prospective Model. Capitation-Structured Model. Data Contained in Accounts Receivable Pipelines. Chapter 6.