Identify Fraud & Abuse through Data Analysis

Read:

• AHIMA Professional Code of Ethics
• Addressing Healthcare Fraud, Waste, and Abuse
• Preventing Provider Fraud through Health IT, Data Analytics
• Top Waste, Fraud, and Abuse Red Flags
• M4 lecture: Waste, Fraud, and Abuse

In your essay:

1. Consider the False Claims Act, whistleblowers, the Anti-Kickback Statute (Stark), unbundling, Upcoding, role of OIG & RAC, and use of copy/paste and templates in the EHR
2. Describe how data analysis identifies potential abuse or fraudulent trends
3. Demonstrate your reading and research by including facts from these in your statements and citing your source(s).
4. Provide a reference list in APA format of your sources that are cited in your essay. Use at least two sources

Attached Files:

• M4 EHRs, Upcoding, Overpayments, and the False Claims Act – Understanding the Risks.pdf M4 EHRs, Upcoding, Overpayments, and the False Claims Act – Understanding the Risks.pdf – Alternative Formats (2.473 MB)
• M4 Preventing Provider Fraud through Health IT, Data Analytics.pdf M4 Preventing Provider Fraud through Health IT, Data Analytics.pdf – Alternative Formats (2.916 MB)
• M4 Top waste, fraud, and abuse red flags, and how to identify them.pdf M4 Top waste, fraud, and abuse red flags, and how to identify them.pdf – Alternative Formats (688.055 KB)
• M4-Providers hope for Stark overhaul to boost value-based payment.pdf M4-Providers hope for Stark overhaul to boost value-based payment.pdf – Alternative Formats (4.606 MB)
• M4D AHIMA Code of Ethics.docx M4D AHIMA Code of Ethics.docx – Alternative Formats (48.337 KB)

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