Course Overview
Health insurance providers, managed care organizations, and other health care stakeholders are increasingly tasked with achieving more on shrinking budgets. This places a premium on strategies that combat and deter the financial effects of health care fraud. With Fraud, Part I (Introduction), you’ll gain valuable expertise in detecting, deterring, and reducing health care fraud, to help you do your job even better
What You’ll Learn
- Explore the methods investigators use to uncover and deter fraud against the health care and health insurance industries
- Compare the different ways fraud schemes work and where they often occur
- Understand how to identify fraudulent practice
- Focus on investigative methods at the organizational level, among health care consumers, and in other arenas where fraud can occur
- Navigate the legal, regulatory, and compliance issues impacting anti-fraud efforts
- Examine relevant terms, case scenarios, and key concepts
Who Should Take This Course
- Agents and brokers
- Claims analysts
- Compliance officers
- Corporate counsel
- Federal regulatory personnel
- Fraud examiners
- Health insurance provider staff
- Legal advisors
- Privacy officers
- State regulatory personnel