Fraud, Part 1 (An Introduction)

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

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