Question

Discvuss the difference between fraud and abuse in healthcare?

Answer 1

Answer :

Difference between fraud and abuse in health care :

Fraud : it is an intentionally misrepresentation made by any person with having knowledge, and also they may get unauthorized benefits to him self or others.

For example : here using the onother persons health care I'd card for health care benefits by forging or changing.

Or

Billing for services that were not provided.

Abuse : in these health care providers are inconsistant with sound or good medical practices, it may leads to unnecessary cost to the health care activities which are provided by health care professionals.

For example : providing services that are medically unnecessary, that means unnecessary consultations for billing purpose, and investigations for billing purpose.

This is the difference between fraud and abuse.