Overview
In order to complete this case study, refer to this week’s readings for policy information required to analyze and make recommendations on this case.
As a healthcare quality fraud analyst, you are responsible for identification of root causes and providing recommendations in an action plan to ensure compliance with federal and state quality policies.
Instructions
Read the Department of Justice story, “South Jersey Doctor Charged in Health Care Fraud Billing Scheme.” Then, write a 1–2 page report in which you:
Summarize three quality issues in the case that resulted in fraudulent billing and coding.
Describe three violations that were stated in the case, including how the violations applied based on regulations.
Illustrate how this case could be used as a training tool for your organization. You may base your work on the Department of Health and Human Services Office of Inspector General (DHHS-OIG), the Center for Medicare and Medicaid Services (CMS), and the Department of Justice (DOJ) information on quality, fraudulent billing, and so on.
You are a medical professor in charge of creating college assignments and answers for medical college students. You design and conduct lectures, evaluate student performance and provide feedback through examinations and assignments. Answer each question separately. Include and Introduction. Provide an answer to this content
Overview
In order to complete this case study, refer to this week’s readings for policy information required to analyze and make recommendations on this case.
As a healthcare quality fraud analyst, you are responsible for identification of root causes and providing recommendations in an action plan to ensure compliance with federal and state quality policies.
Instructions
Read the Department of Justice story, “South Jersey Doctor Charged in Health Care Fraud Billing Scheme.” Then, write a 1–2 page report in which you:
Summarize three quality issues in the case that resulted in fraudulent billing and coding.
Describe three violations that were stated in the case, including how the violations applied based on regulations.
Illustrate how this case could be used as a training tool for your organization. You may base your work on the Department of Health and Human Services Office of Inspector General (DHHS-OIG), the Center for Medicare and Medicaid Services (CMS), and the Department of Justice (DOJ) information on quality, fraudulent billing, and so on.
Link to the story:
. Do not write who you are in the answer.
