Healthcare fraud, waste, and abuse losses are estimated to be as much as $700 billion per year. These losses contribute to rapidly increasing healthcare costs for all Americans and the lack of healthcare or the malpra...Healthcare fraud, waste, and abuse losses are estimated to be as much as $700 billion per year. These losses contribute to rapidly increasing healthcare costs for all Americans and the lack of healthcare or the malpractice of healthcare for money motivations can result in death. The purpose of this article is to describe several different types of healthcare frauds that occurred and to offer suggestions related to the prevention and/or detection of this type of fraud. With a better understanding of the frauds that can take place, auditors can help protect society from both unfair healthcare costs and medical problems.展开更多
A comparison of how MR released to the insurance company Assist Card from a Chinese medical facility Hengyang HP vs from a US facility Stutter Health was roughly displayed. The former MR was for Mafia, a Colombian Ass...A comparison of how MR released to the insurance company Assist Card from a Chinese medical facility Hengyang HP vs from a US facility Stutter Health was roughly displayed. The former MR was for Mafia, a Colombian Assist Card cardholder, worked and got hospitalized in China, the later MR for Kong Lijun, a Chinese StarrChina cardholder, visited and got medical treatments in USA, they shared Assist Card international traveling and insurance assistance. In both cases, Assist Card got MR for the patient from the facilities that gave them treatments. As a third party, Assist Card went through different procedures to claim MR from Hengyang HP vs from Stutter Health. It managed to have got three MRs and three FTF and was pushing a fourth MR from Hengyang HP in about ten days, while it got only one MR from Stutter Health in ten days after twists and turns. The over cooperative or obedient tendency toward Assist Card＇s requests made Hengyang HP vulnerable and controllable, while the strict MR release procedures in Stutter Health made Assist Card passive and helpless.展开更多
文摘Healthcare fraud, waste, and abuse losses are estimated to be as much as $700 billion per year. These losses contribute to rapidly increasing healthcare costs for all Americans and the lack of healthcare or the malpractice of healthcare for money motivations can result in death. The purpose of this article is to describe several different types of healthcare frauds that occurred and to offer suggestions related to the prevention and/or detection of this type of fraud. With a better understanding of the frauds that can take place, auditors can help protect society from both unfair healthcare costs and medical problems.
文摘A comparison of how MR released to the insurance company Assist Card from a Chinese medical facility Hengyang HP vs from a US facility Stutter Health was roughly displayed. The former MR was for Mafia, a Colombian Assist Card cardholder, worked and got hospitalized in China, the later MR for Kong Lijun, a Chinese StarrChina cardholder, visited and got medical treatments in USA, they shared Assist Card international traveling and insurance assistance. In both cases, Assist Card got MR for the patient from the facilities that gave them treatments. As a third party, Assist Card went through different procedures to claim MR from Hengyang HP vs from Stutter Health. It managed to have got three MRs and three FTF and was pushing a fourth MR from Hengyang HP in about ten days, while it got only one MR from Stutter Health in ten days after twists and turns. The over cooperative or obedient tendency toward Assist Card＇s requests made Hengyang HP vulnerable and controllable, while the strict MR release procedures in Stutter Health made Assist Card passive and helpless.
