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Healthcare Fraud: Auditing and Detection Guide

Rebecca S. Busch
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Clearance: original price $78 member, $86 nonmember

According to private and public estimates, approximately $24 million is lost per hour to healthcare waste, fraud, and abuse. Still, the impact of healthcare fraud cannot be measured in terms of dollars alone. In addition to burdening the nation with enormous financial costs, it also threatens the quality of healthcare and steals the very essence of human life. The world of healthcare fraud has become one of high-tech, highly skilled, educated, and professional perpetrators.

Healthcare Fraud: Auditing and Detection Guide serves as an invaluable tool equipping healthcare managers, auditors, and fraud investigators to detect every kind of healthcare fraud, from false statements and claims to elaborate collusive schemes.

Features include:

  • Comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans
  • A look at how data mapping and mining can be used as a key tool to maximize both the effectiveness and efficiency of fraud investigations
  • Insightful discussion from a number of perspectives—clinical, research, internal audit, investigative, data intelligence, and forensic
  • Building blocks for understanding the entire healthcare market and its respective players
  • Cases and methodologies providing actual audit and investigative tools
  • Useful outlines of healthcare fraud prevention, detection, and investigation methods
Format: Hardcover

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