Healthcare Fraud Essentials

Course Overview

Health care fraud involves a deception or misrepresentation that an individual or entity makes, knowing that the misrepresentation could result in some unauthorised benefit to the individual or to the entity or some other party. The most common fraud involves a false statement or a misrepresentation or deliberate omission that is critical to the determination of benefits. Due to the highly technical nature of the health care industry and the broad diversity in payment systems throughout the world, health care fraud schemes can be among the most complex.

Learning Objectives

On completion of this course, you''ll be able to:

  • Understand the types of health care systems;
  • Understand the different types of of health care fraud schemes;
  • Compare the different ways fraud schemes work and where they often occur;
  • Know the various types of healthcare red flags and how to identify the,and
  • Understand how to identify fraudulent practice.

Module 1: Course Overview

Module 2: Types of Health Care Systems

Module 3: Electronic Claims Fraud

Module 4: Provider Fraud

Module 5: Kickbacks in the Health Care Industry

Module 6: Inflated Billings

Module 7: Insured and Beneficiary Fraud

Module 8: Fraud by Insurance Companies

Module 9: Fraud by Medical Institutions

Module 10: Other Frauds in the Institutional Setting

Module 11: Fraud in Special Care Facilities

Price: $95

This Course includes:

   Text-based content

   2 Weeks