Health Insurance Fraud Fundamentals
Course Overview
Health insurance providers, managed care organizations, and other health care stakeholders are increasingly tasked with achieving more on shrinking budgets. This places a premium on strategies that combat and deter the financial effects of health care fraud. With Health Insurance Fraud Fundamentals, you’ll gain valuable expertise in detecting, deterring, and reducing health care fraud, to help you do your job even better and improve the bottom line.
Learning Objectives
What You’ll Learn
- Explore the methods investigators use to uncover and deter fraud against the health care and health insurance industries
- Compare the different ways fraud schemes work and where they often occur
- Understand how to identify fraudulent practice
- Focus on investigative methods at the organizational level, among health care consumers, and in other arenas where fraud can occur
- Navigate the legal, regulatory, and compliance issues impacting anti-fraud efforts
- Examine relevant terms, case scenarios, and key concepts
Who Should Take This Course
- Agents and brokers
- Claims analysts
- Underwriters
- Health insurance provider staff
- Compliance officers
- Corporate counsel
- Federal regulatory personnel
- Fraud examiners
- Legal advisors
- Privacy officers
- State regulatory personnel
- Professionals working in special investigation units (SIUs)
