Health care fraud and abuse
In your billing and coding profession it is critical for you to demonstrate integrity
through the application of relevant codes of conduct and social responsibility.
HIPAA legislation that influences your profession the most is Title II: Preventing
Healthcare Fraud and Abuse.
Starting on page 123 in your text, review the material on Title II and Healthcare
Fraud and Abuse.
Answer the following questions:
What is a false claim?
Are mistakes and errors considered to be fraudulent behavior?
What is the purpose of 3 Compliance Program?
There are seven steps to the compliance program. Think about your role in
insurance billing. Describe the steps where you will be able to have the
greatest impact to help avoid creating erroneous and fraudulent claims.
What are some best practices you could implement within these steps to
ensure you are adhering to Title II?