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 xxxxx Fraud xxx abuse xxxxxxxxxx is xxxxxxxxx for xxxxxxxxxx system xxxxxxxxx and xxxxxxx safety xxxxxxxxxx personnel xxx crucial xx discovering xxx reporting xxxxx and xxxxx We xxx provide xxx best xxxxxxxxx and xxxxxxxxx patients xx remaining xxxxxxx on xxxxxxxxxx rules xxxxxxxx and xxxxxx Follow xxxxxxxxx procedures xx you xxxxxxx workplace xxxxx or xxxxx You xxx need xx tell xxxx supervisor xxxxxxxxxx officer xx the xxxxxx of xxx Inspector xxxxxxx Sampson 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 xxxxx By xxx reporting xxxxxxxxxxx healthcare xxxxxxxxxx risk xxxxxxx suffering xxxxx losses xxx reputation xxxxxx Healthcare xxxxxxxxx may xxxx legal xxx ethical xxxxxxxxxxxx for xxxxxxxxxxxxx in xxxxx By xxxxxxxxx quiet xxxxxxxxxx workers xxxx losing xxxxx core xxxxxxxxxx of xxxxxxx ethics xxx patient-centered xxxx Finally xxxxxxxxxx practitioners xxxx avoid xxxxx and xxxxx We xxx provide xxx best xxxxxxxxx and xxxxxxxxx patients xx being xxxxxxxx following xxxxxx and xxxxxxxxx questionable xxxxxxxx Reporting xxxxx or xxxxx may xxxxxxx patient xxxxxx healthcare xxxxxxxxx and xxxxxx integrity xxxxxxx 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 ReferencesSampson x J xxxxx B xxxxx Resources xx Healthcare xxxxxxxx for xxxxxxx Health xxxxxxxxxxxxxx PressMore Articles From Strategic Management
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