Professional Certificate in Healthcare Fraud: A Strategic Approach
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⢠Introduction to Healthcare Fraud: Overview of healthcare fraud, its impact on the industry, and the importance of a strategic approach.
⢠Types of Healthcare Fraud: Examination of various forms of fraud, including false claims, upcoding, unbundling, and identity theft.
⢠Legal & Regulatory Framework: Analysis of key laws and regulations governing healthcare fraud, such as the False Claims Act, Anti-Kickback Statute, and HIPAA.
⢠Fraud Detection Techniques: Exploration of data analysis, pattern recognition, and other methods used to identify potential fraud.
⢠Investigation & Enforcement: Overview of investigation processes, evidence collection, and enforcement actions taken against fraudsters.
⢠Prevention Strategies: Best practices to prevent healthcare fraud, including internal controls, audits, and employee training.
⢠Compliance Programs: Design and implementation of effective compliance programs to detect, prevent, and address fraud.
⢠Responding to Fraud: Steps to take when fraud is suspected or detected, including reporting requirements and crisis management.
⢠Case Studies: Analysis of real-world examples of healthcare fraud and the strategies used to combat them.
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