HSM420_Week 5_CourseProjectOutline_IfeakamOgwu

HSM420_Week 5_CourseProjectOutline_IfeakamOgwu - Preventing...

Info icon This preview shows pages 1–4. Sign up to view the full content.

View Full Document Right Arrow Icon
Preventing Fraud and Abuse in Managed Care 1 Preventing Fraud and Abuse in Managed Care HSM 420 Ifeakam Ogwu Professor Richard Barrett October 1, 2016
Image of page 1

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Preventing Fraud and Abuse in Managed Care 3 Preventing Fraud and Abuse in Managed Care I Improper payments from CMS A Underutilization of services B US healthcare system 1 Fee for service 2 Extensive high medical care and administrative cost II Medicare and Medicaid programs A Underutilization of services 1 Public healthcare B Program integrity program 1 Monitoring program III Claim and submission program A Balance billing C Double billing D Inflating the bill for services
Image of page 2
Preventing Fraud and Abuse in Managed Care 3 References Barnes, Walter. (2000). “Guidelines for Addressing Fraud and Abuse in Medicaid Managed Care”. Retrieved on September 9, 2016 from: - Prevention/FraudAbuseforProfs/Downloads/GuidelinesAddressingfraudabuseMedMngdCare.pdf Buchbinder, RN, PhD, S. B., & Shanks, PhD, N. H. (2007). Introduction to Health Care Management.
Image of page 3

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 4
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern