What kinds of fraudulent or abusive behavior relating to health care services can occur in hospital...
What kinds of fraudulent or abusive behavior relating to health care services can occur in hospital operations? How does the role of the compliance committee help to monitor and prevent these?
Homework Answers
Some of the major kinds of frauds and abuse in the healthcare sector are
- The services are misinterpreted knowingly or intentionally for monetary gains by the healthcare provider
- The billers billing an unperformed procedure
- Performing procedures on patients without the actual need in relation to the disease condition and its treatment regimen
- Enrolment down in multiple states
- Hacking of patient data and the social security number and most personal details and misusing it
- Patient billing for the service not provided
The Big data has played a key role in monitoring and preventing these frauds and abuse .The Health and Human Service,Health care Fraud and Abuse Control program are the department which oversees and monitors the different activities in the healthcare sector technologies ,data transfer , etc., and providing a secured service in the healthcare sector.
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