Healthcare Fraud: Auditing and Detection Guide, 2nd Edition

Audit Continuum Models Overview: Implications for Prevention, Detection, and Investigation

The complexity of the healthcare industry is multidimensional, fragmented, high volume, and layered with conflicting incentives among numerous parties. The healthcare industry has over and over again demonstrated behaviors that result in counterproductive outcomes. The bottom line is that healthcare is big business with big dollars. The opportunity for the ethically challenged is great. As private benefit programs, patients, and government-sponsored programs continue to struggle with shrinking dollars, efforts need to be made to stop the bleeding, at minimum. The approaches presented in this book have been applied and are offered to enhance and supplement any current initiative or program.