Healthcare fraud [[electronic resource] ] : auditing and detection guide / / Rebecca S. Busch

• Record Nr.: UNINA9910784771303321
• Autore: Busch Rebecca S
• Pubbl/distr/stampa: Hoboken, N.J., : John Wiley & Sons, c2008
• ISBN: 1-281-10030-7; 9786611100308; 0-470-22708-7
• Descrizione fisica: 1 online resource (306 p.)
• Disciplina: 345.73/0263
• Soggetti: Medicare fraud; Medicaid fraud; Medical care - Law and legislation - United States - Criminal provisions
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Includes index.
• Nota di contenuto: Defining market players within the healthcare continuum -- Protected health information -- Health information pipelines -- Accounts receivable pipelines -- Operational flow activity -- Product, service, and consumer market activity -- Data management -- Normal infrastructure -- Normal infrastructure and anomaly tracking systems -- Components of the data mapping process -- Components of the data mining process -- Components of the data mapping and data mining process -- Data analysis models -- Clinical content data analysis -- Profilers -- Market implications.
• Sommario/riassunto: According to private and public estimates, approximately 24 million is lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud: Auditing and Detection Guide 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.