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Healthcare Fraud: Auditing & Detection Guide

Author: Rebecca S. Busch
Publisher: John Wiley & Sons, Inc.

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According to private and public estimates, approximately $24 million is lost per hour to healthcare waste, fraud, and abuse. Still the impact of healthcare fraud cannot be measured in terms of dollars alone. In addition to burdening the nation with enormous financial costs, it also threatens the quality of healthcare and steams the very essence of human life.

A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud: Auditing and Detection Guide provides tips and techniques to help you spot - and prevent - the "red flags" of fraudulent activity within your organization.

Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations.

Praise for Healthcare Fraud: Auditing and Detection Guide

"The cost of health care fraud continues to escalate each year. It is a terrible burden on our already fragile health care system. This book will provide anti-fraud professionals with a valuable resource to help combat this critical problem."

—James D. Ratley, CFE
   President, Association of Certified Fraud Examiners

"Fraud continues to be a major subject area for internal auditors. Recent studies by The IIA show that health care audits are in the top 10 subject areas audited. This document speaks to the necessary background that internal auditors should have when auditing health care activities so that they can have the necessary skills to look for and deal with potential fraudulent situations. I recommend this book be part of every internal audit department's library."

—Dave Richards, CIA, CPA
   President, The Institute of Internal Auditors

"Rebecca Busch has taken the cumbersome and complex subject of healthcare fraud and dissected it into well-defined parts. Her thoughtful discussion of how and where these parts provide opportunities for fraud—and how to detect and prevent it—is the essence of this work. This book is a must read for anyone involved in the prevention, detection and investigation of healthcare fraud."

— Robert M. Bryant
   President and Chief Executive Officer, National Insurance Crime Bureau

"Rebecca Busch’s Healthcare Fraud: Auditing and Detection Guide fills a critical gap in anti-fraud literature. Written professionally and precisely, yet eminently readable, this book will be the “go to” source for managers, academics, attorneys, auditors and fraud examiners involved in healthcare. Healthcare Fraud: Auditing and Detection Guide demonstrates Ms. Busch’s expertise and depth of knowledge in the area of healthcare fraud, and is testimony as to why she is such a sought after speaker and educator."

—William J. Kresse, MS, JD, CPA, CFE
   Assistant Professor, Saint Xavier University
   Graham School of Management
   2007 ACFE Educator of the Year