Healthcare Fraud: Auditing and Detection Guide

  • Item No. : 6136
  • ISBN : 978-0-470-12710-0
  • Publisher : John Wiley & Sons Inc.
  • Publish Date : 2007
  • Authors : Rebecca S. Busch
  • Media : Hardcover
  • Page count : 286
  • Dimensions : 6.25 x 9.5
  • Member Price : $78.95
  • Non-Member Price : $78.95

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A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud: Auditing and Detection Guide provides tips and techniques to help readers spot the "red flags" of fraudulent activity and reveals the steps to take when fraud is suspected.

Clearly structured to identify what is normal at any point in the healthcare continuum on both individual and cumulative scales, this timely guidebook helps auditing professionals in the healthcare industry to sharpen their fraud detection skills to see beyond the eclipse created by healthcare fraud. The book features:
  • Comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans
  • A look at how data mapping and mining can be used as a key tool to maximize both the effectiveness and efficiency of fraud investigations
  • Insightful discussion from a number of perspectives—clinical, research, internal audit, investigative, data intelligence, and forensic
  • Building blocks for understanding the entire healthcare market and its respective players
  • Cases and methodologies providing actual audit and investigative tools
  • Useful outlines of healthcare fraud prevention, detection, and investigation methods
"Fraud continues to be a major subject area for internal auditors. Recent studies by The IIA show that healthcare audits are among the top 10 subject areas audited. This book speaks to the necessary background and skills that internal auditors should have when auditing healthcare activities so that they can more readily recognize and effectively deal with potential fraudulent situations."
 
David A. Richards, CIA
Former President, The Institute of Internal Auditors
 

 

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