Question.1475 - Week 7: Discussion - Introduction to Coding and Reimbursement James Lewis 1212 unread replies.1818 replies. Week 7: Fraud is an act that represents a crime against payers or other health care programs (e.g., Medicare), or an attempt or conspiracy to commit those crimes. Abuse is a pattern of practice that is inconsistent with sound business, fiscal, or health service practices and which results in unnecessary costs to payers and government programs (e.g., Medicare), reimbursement for services not medically necessary, or failure to meet professionally recognized standards for health services. Discuss the importance of how you as a healthcare professional play a role in the prevention of fraud and abuse. What would you do if you believe fraud or abuse is taking place in your work environment. Discuss the potential benefit to you, your co-workers and your employer by reporting fraud or abuse as well as the potential detrement for not reporting fraud or abuse. Discussion Guidelines: Each week you will have a topic to answer and then respond to at least two classmates. This means, that if you follow the minimum posting requirements you will have one main substantive answer in each thread, and one response to at least two classmates. Altogether 3 posts, 2 of which will be on different days of the week. Be sure to check in if you have questions. Grading rubric for discussion posting per thread: Main post - 10 points (high quality) Response posts - 10 points (total of all responses) Post by Wednesday - 5 points
Answer Below:
Healthcare xxxxxxxxxxxxx must xxxxxxxxxx fraud xxx abuse xxx how xx avoid xxxx Healthcare xxxxx is xxxxxxxxx defrauding xxxxxxxx like xxxxxxxx for xxxxxx Abuse xxxxx place xxxx healthcare xxxxxxxxx are xxxxxxx and xxxxxx pay xxxxxxxx expenditures xxxxx and xxxxx may xxxx patients xxxxxx and xxx healthcare xxxxxx Sampson xxx Fried xxxxx and xxxxx prevention xx essential xxx healthcare xxxxxx integrity xxx patient xxxxxx Healthcare xxxxxxxxx are xxxxxxx in xxxxxxxxxxx and xxxxxxxxx fraud xxx abuse xx can xxxxxxx the xxxx treatment xxx safeguard xxxxxxxx by xxxxxxxxx current xx healthcare xxxxx policies xxx ethics xxxxxx reporting xxxxxxxxxx if xxx suspect xxxxxxxxx fraud xx abuse xxx may xxxx to xxxx your xxxxxxxxxx compliance xxxxxxx or xxx Office xx the xxxxxxxxx General xxxxxxx amp xxxxx Healthcare xxxxxxxxxxxxxx are xxxxxxxxx from xxxxxxxx for xxxxxxxxxx fraud xx abuse xxxxxxxxx fraud xx abuse xx ethical xxx may xxxxxxx you xxxx colleagues xxx your xxxxxxx Reporting xxxxxxxxxx promotes xxxxxxx safety xxx efficient xxxxxxxxxx resource xxxxx This xxxxxxxx treatment xxx maintains xxxxxxxxxx system xxxxxxxxxx Reporting xxxxx or xxxxx may xxxx save xxxxxx money xxxxxxxx healthcare xxxxx Not xxxxxxxxx fraud xx abuse xxx have xxxxxxxxxxxx Sampson xxx Fried xx not xxxxxxxxx misbehavior xxxxxxxxxx facilities xxxx patient xxxxxxxxx payer xxxxxx and xxxxxxxxxx damage xxxxxxxxxx personnel xxx face xxxxx and xxxxxxx implications xxx participating xx fraud xx remaining xxxxx healthcare xxxxxxx risk xxxxxx their xxxx principles xx honesty xxxxxx and xxxxxxxxxxxxxxxx care xxxxxxx healthcare xxxxxxxxxxxxx must xxxxx fraud xxx abuse xx can xxxxxxx the xxxx treatment xxx safeguard xxxxxxxx by xxxxx watchful xxxxxxxxx ethics xxx reporting xxxxxxxxxxxx activity xxxxxxxxx fraud xx abuse xxx protect xxxxxxx safety xxxxxxxxxx resources xxx system xxxxxxxxx Sampson xxx Fried xxxxxxx the xxxxx of xxx reporting xxxxxxxxxxx emphasize xxx need xx uphold xxxxxxxxxx ethics xxx law xxxxxxxxx fraud xxx abuse xx a xxxxx and xxxxxxxxxxxx commitment xx protect xxxxxxxx and xxx healthcare xxxxxx nbsp xxxx ReferencesSampson x J xxx Fried x Human xxxxxxxxx in xxxxxxxxxx Managing xxx Success xxxxxx Administration xxxxxMore Articles From Strategic Management
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