Healthcare fraud [electronic resource] : auditing and detection guide / Rebecca Saltiel Busch
- Busch, Rebecca S.
- Additional Titles:
- Health care fraud
- Hoboken, N.J. : John Wiley & Sons, c2012.
- 2nd ed.
- Physical Description:
- xviii, 340 p. : ill. ; 24 cm.
- Restrictions on Access:
- License restrictions may limit access.
- Introduction to healthcare fraud -- Defining market players within the primary healthcare continuum -- Continuum audit and investigative model -- Secondary healthcare continuum -- Information healthcare continuum -- Consequence healthcare continuum -- Transparency healthcare continuum -- Rules based 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 -- Conclusions.
- "This second edition provides comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans. New chapters have been added covering a comprehensive auditing model developed by the author on all of the key elements that must be addressed: Primary Healthcare, Secondary Healthcare, Information/Data Management and Privacy, Damages/Risk Management, and transparency. In addition to six new chapters, the current edition material will all be updated and brought up to date"--Provided by publisher.
- 9781118179802 (cloth), 9781118227220 (ebk), 9781118240250 (ebk), and 9781118264959 (ebk)
- Bibliography Note:
- Includes bibliographical references and index.
View MARC record | catkey: 19476587