The fraud-prevention playbook: How payer Chief Risk Officer can safeguard revenue and protect patients
Healthcare fraud schemes can do major harm to hospitals, patients and payers. Healthcare fraud schemes are becoming increasingly complex, and many cannot be detected by current payment integrity solutions or manual investigation. Industry experts understand that healthcare fraud schemes will continue to become more sophisticated.
Healthcare technology leaders must take action to modernize fraud protection. If they don't, the industry will continue to fall prey to many more of these schemes.
This two-part guide offers insights into emerging best practices in fraud protection. Key learnings include:
Healthcare technology leaders must take action to modernize fraud protection. If they don't, the industry will continue to fall prey to many more of these schemes.
This two-part guide offers insights into emerging best practices in fraud protection. Key learnings include:
- An overview of the healthcare fraud landscape
- A snapshot of a real-world fraud case
- An examination of the role technology plays in both fraud protection and fraud susceptibility
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