What Should Health Care Organizations Do to Reduce Billing Fraud and Abuse?
Document Type
Article
Publication Date
2020
Digital Object Identifier (DOI)
https://doi.org/10.1001/amajethics.2020.221.
Abstract
Whether physicians are being trained or encouraged to commit fraud within corporatized organizational cultures through contractual incentives (or mandates) to optimize billing and process more patients is unknown. What is known is that upcoding and misrepresentation of clinical information (fraud) costs more than $100 billion annually and can result in unnecessary procedures and prescriptions. This article proposes fraud mitigation strategies that combine organizational cultural enhancements and deployment of transparent compliance and risk management systems that rely on front-end data analytics.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
AMA Journal of Ethics, v. 22, issue 3, p. 221-231
Scholar Commons Citation
Drabiak, Katherine and Wolfson, Jay, "What Should Health Care Organizations Do to Reduce Billing Fraud and Abuse?" (2020). Health Policy and Management Faculty Publications. 22.
https://digitalcommons.usf.edu/hpm_facpub/22
