Exam (elaborations)
Fraud, Waste And Abuse In Healthcare – Qs & As
- Course
- Institution
Fraud, Waste And Abuse In Healthcare – Qs & As
[Show more]
Seller
Follow
LeCrae
Reviews received
Content preview
Fraud, Waste And Abuse In Healthcare – Qs & AsWhat is healthcare fraud? ✔️Ans - •includes illegal acts that are performed
for financial gain
•Knowingly and willingly committing these acts
•Occur when an insurer is billed for services or medical devices that didn't
occur or weren't needed
Who can be stakeholders in committing healthcare fraud? ✔️Ans - Can be
from a variety of stakeholders
1. Crime rings improperly billing Medicare
2. Physicians charging for and performing a more complex procedure then is
necessary
3. Healthcare systems defrauding Medicare and Medicaid
4. Individual sharing their healthcare information with another person
What are some examples of Medicare fraud? ✔️Ans - •Knowingly billing
for services not furnished or supplies not provided, including billing for
appointments patients didn't keep
•Billing for nonexistent prescriptions
•Altering claim forms, medical records, or receipts to receive higher payment
What are whistleblowers? ✔️Ans - Person who exposes information or
activity that is demmed illegal, dishonest or violates professional or Clinical
standards
-no penalty for whistleblower
What is the anti-kickback statute? ✔️Ans - Prohibits knowing and willful
offer, actual payment of any type of payment to refer an individual for a
service or item that might be paid for under a federal health program.
•Only applies to federal programs. (medicare/Medicaid)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
74735 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now