Fraud and Abuse
Every healthcare fraud investigator is familiar with laboratory testing, since over one third of all patient encounters involve at least one laboratory test.
To address laboratory services fraud and abuse, investigators need a basic framework for prevention, detection and investigation.
In this white paper, you'll learn about:
Common problems with lab orders, as well as issues related to credentialing and oversight of labs
Improper billing practices
Practices for preventing fraud like screening providers and implementing controls related to payment policies and edits
Techniques to detect fraud and abuse by capturing the ordering provider ID/NPI and running various types of analytics
Best practices for investigating fraud and abuse such as desk audits, verification of ordering providers, lab record reviews, and on-site audits and inspections