Types of Fraud
Government Enforcement/Prevention Networks
100
This type of fraud constitutes billing for more expensive services or procedures than were actually provided or performed
What is up-coding
100
This network was jointly founded by prevention networks from Europe, Canada, the UK and the US
What is GHCAN (Global Health Care Anti-Fraud Network)
200
This type constitutes billing for each step of a procedure as if it were a separate procedure
What is unbundling
200
The implementation of this system assisted in generating over 500 new investigative leads and prompting over 2000 provider and beneficiary interviews
What is Fraud Prevention System
300
This act involves a physician or group of physicians enticing an outsider to generate additional patient referrals in exchange for compensation
What are kickbacks
300
This network is a not-for-profit organization based in Brussels and represents 25 member associations in 15 countries
What is EHFCN (European Healthcare Fraud & Corruption Network)
400
This type consists of the use of a member ID card which does not belong to the individual attempting to receive health benefits
What is Medical Identity Theft
400
This partnership was designed as a forum promoting the collective exchange of information and resources regarding the best practices against fraud
What is Health Fraud Prevention Partnership
500
This form of fraud involves an individual visiting several doctors in order to obtain multiple prescriptions
What is Doctor Shopping
500
This statute is regarded as having the most dramatic impact on healthcare fraud prevention
What is HIPAA
M
e
n
u