Description #

A 45 minute reusable teaching module on Medicare and Medicaid billing fraud, written to be delivered by a trained volunteer with no clinical or technical background. Covers how a beneficiary's number is misused to generate false claims, the specific signals in the approach and in the paperwork afterward, the single action to take, and where to report. Includes delivery timing, a specimen Medicare Summary Notice exercise, facilitator notes for handling disclosures, and a derivation table showing that each recognition cue is a direct restatement of a measurement from the provider level claims anomaly detection work in Initiative 1.

Files #

PathSizeSHA-256
files/module-02-medicare-and-medicaid-billing-fraud.pdf 157,461 bytes c671bf58c5f5f3f76291794ee84d1c987eb4ffa314b163ade9befdf4878fbb5e

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Licence: CC BY 4.0

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