1st Edition
License To Steal How Fraud Bleeds America's Health Care System, Updated Edition
By Malcolm K. Sparrow
Copyright 1996
256 Pages
by
Routledge
256 Pages
by
Routledge
256 Pages
by
Routledge
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This book brings an unusual opportunity to explore the peculiarities of America's health care industry's approach to fraud control, when compared with the financial services sector, credit card companies, or the Internal Revenue Service—all of which have to defend themselves against fraud.
Foreword -- Preface -- Introduction -- Understanding the Fraud-Control Challenge -- The Pathology of Fraud Control -- Particular Challenges in the Health Care Field -- The Importance of Measurement -- Assessment of Fraud-Control Systems -- The Antithesis of Modern Claims Processing -- Current Developments -- Electronic Claims Processing -- Managed Care -- Prescription for Progress -- A Model Fraud-Control Strategy -- Detection Systems -- Conclusion -- Appendix: Site Selection and Interview Subjects
