Global Certificate Healthcare Fraud & Abuse Mitigation
-- ViewingNowThe Global Certificate in Healthcare Fraud & Abuse Mitigation is a comprehensive course designed to tackle the growing challenge of healthcare fraud and abuse. This program emphasizes the importance of detecting, preventing, and mitigating fraud, which costs the healthcare industry billions annually.
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โข Introduction to Healthcare Fraud & Abuse: Definition, types, and impact on the healthcare system.
โข Understanding Healthcare Regulations: Overview of federal and state laws, regulations, and reporting requirements.
โข Identifying Fraud Schemes: Common methods and indicators of healthcare fraud, including upcoding, unbundling, and phantom billing.
โข Data Analysis Techniques: Utilizing data analytics to detect and prevent healthcare fraud and abuse.
โข Compliance Programs: Designing, implementing, and monitoring effective compliance programs to prevent and detect fraud and abuse.
โข Investigative Techniques: Conducting internal investigations, gathering evidence, and interviewing techniques.
โข Sanctions and Penalties: Overview of civil and criminal penalties, fines, and exclusions for healthcare fraud and abuse.
โข Ethics in Healthcare Fraud & Abuse Mitigation: Understanding ethical considerations and responsibilities in identifying, reporting, and preventing fraud and abuse.
โข Case Studies: Analysis of real-world cases to illustrate the concepts and techniques covered in the course.
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