discuss policies and actions at my hospital to prevent fraud‚ acting as a CEO of a hospital. No research is needed to tell anyone that the greed of money is the major reason why any sort of fraud occurs. In the healthcare industry‚ physicians‚ hospital administrators‚ and other healthcare professionals commit fraud by receiving kickbacks for unprovided goods and services. According to the Centers for Disease Control and Prevention (CDC)‚ “health care fraud perpetrators steal billions of dollars
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According to the Tampa Tribune‚ Shands Healthcare paid the federal government and Florida a total of $26 million to settle allegations of false claims to Medicare‚ Medicaid and TRICARE‚ according to a statement from the Department of Justice. The facilities at Shands were billing state and federal health care programs from 2003 to 2008 for inpatient services and procedures that should have been recorded as outpatient care (The Tampa Tribune‚ 2013). The VA had its share of problems as well. The Senate
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Due to the changing nature of healthcare in America‚ HFMA is always helping its members meet the challenges in the industry by providing certain services. HFMA resources help improve the business caring for finance‚ clinical‚ and operations leaders. Some of the services and functions of the HFMA are: • Creating solid and practical strategies for moving forward • Providing the tools and information for members to stay ahead of fast-moving developments • Connection to the trend and pace setters of
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Date: February 24‚ 2013 Subject: PHYSICIAN COMPENSATION Enclosed is a formal report on physician compensation. Intermountain Healthcare is in the process of deciding if changing how physicians are compensated is pertinent to improving Intermountain Healthcare’s motto of‚ “extraordinary care” and financial wellbeing. This report describes how Intermountain Healthcare is looking at using the government enacted Stark regulation system. This system uses RVUs (relative value units) in determining
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To stay afloat in today’s economy‚ healthcare organizations need to reorganize and simplify inefficient processes and understand the types and amount of resources they need to deliver care across the establishment. This can only be achieved by applying effective cost allocation methods to indirect costs‚ including direct allocation and the step-down method. Further‚ in regard to patient-level costs‚ these organizations should practice common cost allocation methods by taking into account cost drivers
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program. o The role technology will play in health care organizations in the coming decade. o The financial and economic issues that will affect the health care industry in the next 10 years. With about 10 years of experience‚ as a secretary‚ in healthcare industry‚ I’ve noticed a multitude of changes within the medical field. On many levels‚ the medical system has changed‚ from paper charts to computerized patient files‚ the way prescriptions are handled and distributed‚ to file and/or medical documentation;
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HEALTHCARE FRAUD Abuse AND Prevention Health care fraud is a crime. Fraud is committed when a provider or patient intentionally submits false or misleading information to a health plan for use in determining the amount of health care benefits payable. As a Group Health member‚ there are steps you can take to prevent health care fraud and to report suspected fraud and abuse. There are a lot of things people can do to prevent Healthcare fraud some things that can be done Start by knowing your benefits
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Healthcare practitioners build a patient’s history through health history effective communication to provide quality health care. Therefore‚ the success of diagnosis emanates from effective communication with the patient. This paper seeks to discuss the potential health-related risks and a description of the interview and communication techniques for a 76-year-old Black African-American male with disabilities living in an urban setting. The health-related risks would entail the patient’s environmental
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Name: Investing in Private Equity (INPE) Assignment Title: Orchid Partners Section B Submitted by: Group Member Name Shikher Gupta Anand Vishwarupe Manvender Singh Shrivats Kanodia Venkat Tummala Avinash Balani PG ID 61510405 61510658 61510610 61510529 61510573 61510818 1 Orchid Partner Case Write-up Orchid Partners is a venture capital start-up initiated by Susan Pravada with other general partners. These general partners committed an average of approx. $2 M to get the fund started. In this
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A White Paper on Strategic BPO in the US Healthcare Industry The Current Healthcare Environment The healthcare environment today faces challenges that it has never seen before. The industry is under attack from every possible direction from cost containment‚ HIPAA (Health Insurance Portability & Accountability Act) compliance‚ lack of stability‚ to an uncertain future. After trying various managed care techniques and concepts the
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