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Healthcare Fraud

Author: Rebecca S. Busch
Publisher: John Wiley & Sons
ISBN: 1118240251
Size: 24.20 MB
Format: PDF
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An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud 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. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities 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.

Leveraging Data In Healthcare

Author: Rebecca Mendoza Saltiel Busch
Publisher: CRC Press
ISBN: 1498757731
Size: 40.59 MB
Format: PDF, ePub, Docs
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The healthcare industry is in a state of accelerated transition. The proliferation of data and its assimilation, access, use, and security are ever-increasing challenges. Finding ways to operationalize business and clinical data management in the face of government and market mandates is enough to keep most chief officers up at night! Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data argues that the key to survival for any healthcare organization in today’s data-saturated market is to fundamentally redefine the roles of chief information executives—CIOs, CFOs, CMIOs, CTOs, CNIOs, CTOs and CDOs—from suppliers of data to drivers of data intelligence. This book presents best practices for controlling, analyzing, and using data. The elements of preparing an actionable data strategy are exemplified on subjects such as revenue integrity, revenue management, and patient engagement. Further, the book illustrates how to operationalize the electronic integration of health and financial data within patient financial services, information management services, and patient engagement activities. An integrated environment will activate a data-driven intelligent decision support infrastructure. The increasing impact of consumer engagement will continue to affect the organization’s bottom line. Success in this new world will need collaboration among the chiefs, users, and data creators.

White Collar And Corporate Crime A Documentary And Reference Guide

Author: Gilbert Geis
Publisher: ABC-CLIO
ISBN: 0313380554
Size: 59.78 MB
Format: PDF, ePub, Mobi
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This reference guide documents white-collar crimes by individuals and businesses over the past 150 years, offering the most comprehensive array of documents and interpretations available. • Provides dozens of court documents, legislative hearing transcripts, muckraking articles, and accounts of crooked behavior in the upper echelons of power • Contains numerous photographs that illustrate the subject material • Includes a bibliography in each section that directs readers to supplementary sources

Electronic Health Records

Author: Rebecca S. Busch
Publisher: John Wiley & Sons
ISBN: 0470399465
Size: 21.60 MB
Format: PDF, Mobi
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Electronic Health Records: An Audit and Internal Control Guide describes the infrastructure of electronic health records and the impact that the government's new criteria will have on the private and public marketplace. Understand what to look for in a health care record management system and find tips and helpful guidance for implementation. If you are trying to facilitate an audit of a health record management system, you can apply the example described in the model, which will serve as a timely model and invaluable resource.

Computer Aided Fraud Prevention And Detection

Author: David Coderre
Publisher: John Wiley & Sons
ISBN: 9780470451618
Size: 53.63 MB
Format: PDF, ePub
View: 1136
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Praise for Computer-Aided Fraud Prevention and Detection: A Step-by-Step Guide "A wonderful desktop reference for anyone trying to move from traditional auditing to integrated auditing. The numerous case studies make it easy to understand and provide a how-to for those?seeking to implement automated tools including continuous assurance. Whether you are just starting down the path or well on your way, it is a valuable resource." -Kate M. Head, CPA, CFE, CISA Associate Director, Audit and Compliance University of South Florida "I have been fortunate enough to learn from Dave's work over the last fifteen years, and this publication is no exception. Using his twenty-plus years of experience, Dave walks through every aspect of detecting fraud with a computer from the genesis of the act to the mining of data for its traces and its ultimate detection. A complete text that first explains how one prevents and detects fraud regardless of technology and then shows how by automating such procedures, the examiners' powers become superhuman." -Richard B. Lanza, President, Cash Recovery Partners, LLC "Computer-Aided Fraud Prevention and Detection: A Step-by-Step Guide helps management and auditors answer T. S. Eliot's timeless question, 'Where is the knowledge lost in information?' Data analysis provides a means to mine the knowledge hidden in our information. Dave Coderre has long been a leader in educating auditors and others about Computer Assisted Audit Techniques. The book combines practical approaches with unique data analysis case examples that compel the readers to try the techniques themselves." -Courtenay Thompson Jr. Consultant, Courtenay Thompson & Associates