healthcare fraud investigation guidebook

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Healthcare Fraud Investigation Guidebook

Author : Charles E. Piper
ISBN : 9781498752619
Genre : Law
File Size : 52. 50 MB
Format : PDF, Mobi
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Some have estimated that healthcare fraud in the United States results in losses of approximately $80 billion a year. Although there are many books available that describe how to "detect" healthcare fraud, few address what must be done after the fraud is detected. Filling this need, Charles Piper’s Healthcare Fraud Investigation Guidebook details not only how to detect healthcare fraud, but also how to "investigate" and prove the wrongdoing to increase the likelihood of successful prosecution in court. The book starts by covering the history of healthcare insurance and the various types of fraud schemes. It presents Charles Piper’s unique approach to investigating (The Piper Method) which allows readers to conduct as many as 10 simultaneous investigations for each case. It emphasizes the importance of simultaneously searching for waste and abuse as well as systemic weaknesses and deficiencies that caused or contributed to the problem or wrongdoing under investigation and then make recommendations for improvement. It also provides: Questions to ask whistleblowers, complainants, employers, employees, and healthcare providers who are suspects Tips on investigative case planning, goals, and strategies Sample visual aids for use when briefing others about your investigative findings Guidance on presenting information obtained from healthcare investigations and on how to testify in court Techniques for uncovering previously undetected fraud The book includes a sample case study that walks readers through a mock case—from the time the case is received through the end. The case study demonstrates how to initiate, plan, and conduct a thorough and complete healthcare fraud investigation while incorporating Piper’s proven methodology. Sharing insights gained through Charles Piper’s decades of experience as a federal special agent and certified fraud examiner, the Healthcare Fraud Investigation Guidebook aims to revolutionize the way that healthcare fraud investigations are conducted. It provides the understanding you need to not only put a bandage on the problem of healthcare fraud, but to actually start curing the greed that is poisoning the healthcare industry.

Contract And Procurement Fraud Investigation Guidebook

Author : Charles E. Piper
ISBN : 9781351697217
Genre : Social Science
File Size : 30. 67 MB
Format : PDF, Mobi
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Contract and procurement fraud, collusion, and corruption are worldwide problems. Such wrongdoing causes federal, state, and local governments, as well as private-sector corporations and businesses, to lose funds and profits, while the wrongdoers unjustly benefit. Bid riggers conspire to eliminate fair and open competition and unjustly increase prices, allowing some to monopolize industries. Too often, contracting officials and others responsible for placing orders or awarding contracts compromise their integrity and eliminate fair and open competition to favor vendors offering bribes or gifts. This results in unfair playing fields for vendors and causes financial losses for businesses, government agencies, and taxpayers. Charles Piper’s Contract and Procurement Fraud and Corruption Investigation Guidebook educates readers on fraud and corruption schemes that occur before, during, and after contracts are awarded. This book teaches not only how to identify such wrongdoing, but also how to investigate it and prevent reoccurrence. Piper shares the Piper Method of Conducting Thorough and Complete Investigations, his innovative and proven method of investigating contract and procurement fraud, and demonstrates its principles with personal, on-the-job examples (which he calls "War Stories") woven throughout the text. Intended for criminal justice students, as well as investigators, auditors, examiners, business owners, policy-makers, and other professionals potentially affected by fraud, this book is a must-read guide to effective procurement and contract fraud investigations from inception to testimony.

Investigator And Fraud Fighter Guidebook

Author : Charles E. Piper
ISBN : 9781118871171
Genre : Business & Economics
File Size : 71. 47 MB
Format : PDF, Kindle
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Investigator and Fraud Fighter Guidebook provides investigative insight and guidance on how to conduct thorough and complete investigations. The methods taught will allow investigators to solve more cases – even with fewer resources. The author teaches how investigators should perform as many as ten different types of investigations simultaneously: 1. Criminal , 2. Civil, 3. Administrative, 4. ID similar wrongful acts by same suspect, 5. ID other wrongful acts by same suspect, 6. ID others who have committed same wrongs as suspect, 7. Project others who might commit similar acts in future, 8. ID Waste/Abuse, 9. ID Systemic Weaknesses (Cause/Contributing Factors), 10. Consider improvements/corrections to be made (to ensure the wrong does not reoccur).

Healthcare Fraud

Author : Rebecca S. Busch
ISBN : 0470227087
Genre : Business & Economics
File Size : 55. 88 MB
Format : PDF, Mobi
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According to private and public estimates, approximately $24 million is lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud: Auditing and Detection Guide provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your “go-to” resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations.

Medical Practice Valuation Guidebook 2001 2002

Author : Mark O. Dietrich
ISBN : 1893190099
Genre :
File Size : 89. 79 MB
Format : PDF, Docs
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Guidebook To The Laws Governing The Practice Of Medicine By Physicians And Surgeons

Author :
ISBN : UCSD:31822021846845
Genre : Drugs
File Size : 49. 9 MB
Format : PDF, ePub, Mobi
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The Psychotherapists Guide To Managed Care In The 21st Century

Author : Sondra Tuckfelt
ISBN : 0765700026
Genre : Medical
File Size : 65. 93 MB
Format : PDF
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This work covers the theory and practice of short-term therapy. The text deals with patient confidentiality, outlines specific psychotherapeutic techniques with alternatives, and provides sample forms for patient files and treatment reports, as well as highlighting incidents of managed care abuse.

Modern Healthcare

Author :
ISBN : UOM:49015003021343
Genre : Health facilities
File Size : 51. 86 MB
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Bowker S Law Books And Serials In Print

Author : Bowker Staff
ISBN : IND:30000039776061
Genre : Law
File Size : 77. 55 MB
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The Martindale Hubbell Law Directory

Author :
ISBN : STANFORD:36105060294357
Genre : Court calendars
File Size : 76. 77 MB
Format : PDF, ePub, Docs
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