UNCOVERING & INVESTIGATING INSURANCE HEALTHCARE CLAIMS FRAUD An Insurance Claims Investigation And Control Manual By: Robert P. Campbell, ALHC, HIA

UNCOVERING AND INVESTIGATING INSURANCE
HEALTHCARE CLAIMS FRAUD
An Insurance Claims Investigation And Control Manual
By: Robert P. Campbell, ALHC, HIA

Healthcare fraud seems to be accelerating at an alarming rate-here is a manual to combat it. This powerful manual was originally compiled for Special Investigation Units inside insurance companies on how to go about the detection and investigation of insurance claims healthcare fraud. The book addresses both individual claims fraud and provider claims fraud and is a leading combat tool for the insurance claims industry. The book includes checklists for fraud detection, other detection tools, internet information, and mandated training. The manual is unique in that it contains copies of the various forms from states that mandate that they be notified of any potential fraud situation. It also contains listings of the various state SIU's and how they many be located. It's also a sourcebook of addresses, telephone numbers and information any healthcare fraud investigator would want and need to know.

CHAPTERS INCLUDE:

• INTRODUCTION
• DEFINITION OF FRAUD
• MANDATED TRAINING
• STATE FRAUD UNITS/STATE FORMS/LEGISLATION
• CONDUCTING INDIVIDUAL INVESTIGATIONS
• CONDUCTING PROVIDER INVESTIGATIONS
• CONDUCTING FOREIGN CLAIMS INVESTIGATIONS
• WAIVER OF COPAYMENT/DEDUCTIBLES
• STATE MEDICAL BOARDS
• STATE BOARDS/PREPARATION OF EVIDENCE
• INTERNAL REPORTS/RECORDS
• INDEX

This new manual is brimming with the investigative techniques, checklists, forms, sources of information and know-how you need to fight medical fraud. 8 1/2 X 11, 123 pages. $45.00

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