Chapter 10
Health Information Pipelines
Health is not valued till sickness comes.
–Dr. Thomas Fuller (1654–1734), Gnomologia (1732)
Money, like health, often is not valued until it has come and gone. Unfortunately, the pay-and-chase mode still rules in the fraud world. Understanding the operational channels, communication pathways for health information, and money flows is critical in any audit or investigation. This chapter walks you through model audit health information pipelines (HIPs). An HIP identifies the route and use of health information. It should include patient information, operational information, and financial information in the delivery of patient services and resources. Use the guidelines in this chapter to help you identify all the appropriate layers for your audit.
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