Based on Chapter 18, discuss the most common Claims and Benefits Administration problems, their repercussions, and how to identify and rectify them.
Based on Chapter 19, reflecting on the existence of relevant and emerging statutes, including Fraud Enforcement Recovery Act and the Patient Protection and Affordable Care Act, on health care fraud control – discuss the significant legal and regulatory issues associated with fraud prevention and control.
Kongstvedt, Essentials of Managed Care, Sixth Edition ISBN: 978-1-4496-5331-6
