Spelling suggestions: "subject:"amedical care corrupt practices"" "subject:"amedical care korrupt practices""
1 |
Healthcare fraud and non-fraud healthcare crimes: A comparisonPonce, Michael 01 January 2007 (has links)
Healthcare fraud is a major problem within the healthcare industry. The study examined medical fraud, its laws, and punishments on federal and state levels. It compared medical fraud to non-fraud crimes done in the healthcare industry. This comparison will be done on a state level. The study attempted to analyze the severity of fraud against non-fraud and that doctors would commit fraud offenses more often than non-fraud offenses.
|
2 |
Mitigating fraud in South African medical schemesLegotlo, Tsholofelo Gladys 10 1900 (has links)
The medical scheme industry in South Africa is competitive in relation to international standards. The medical scheme sector, as part of the healthcare industry, is negatively affected by the high rate of fraud perpetrated by providers, members and syndicates, which results in medical schemes funding fraudulent claims. The purpose of the study was to explore strategies to mitigate fraud in medical scheme claims. A qualitative research methodology was followed in this study, which adopted a case study approach. Empirical data was analysed through thematic analysis, with the aid of ATLAS.ti software. The study found that healthcare service providers mainly defraud medical schemes by submitting false claims. A holistic approach should be followed to mitigate fraud in medical scheme claims. This approach should encompass regularly identifying trends in fraudulent claims and implementing appropriate control strategies. Collaboration within the medical scheme industry and with other stakeholders would also help to elevate the fight against medical scheme fraud to a new level. Implementing the recommendations from the study will assist medical schemes to reduce the funds expended on fraudulent claims, thereby improving their financial viability and decreasing the rate of increase in medical scheme contributions for members. / Business Management / M. Com. (Business Management)
|
Page generated in 0.1037 seconds