According to the National Library of Medicine, managed care refers to a healthcare insurance approach that integrates the financing of care and related services to
Medical Loss Ratio (MLR) fraud occurs when plans knowingly misrepresent a proportion of funds spent on patient care and quality improvement measures as opposed to
Medicare Advantage is a type of health insurance plan offered by private companies contracted by the government. Also known as Medicare Part C, Medicare Advantage
Medical fraud is a pervasive issue that undermines the integrity of the healthcare system, affecting patients, providers, and taxpayers alike. As healthcare costs continue to
Medical billing fraud is a rampant problem that affects all areas of the healthcare industry. Unfortunately, rehabilitation (rehab) therapy fraud is on the rise, posing
Medical doctors should be able to focus on providing the best possible care for their patients. However, in the complex world of healthcare, it’s not
In the ever-evolving landscape of healthcare, advancements in technology continue to shape the industry. One area that has garnered attention is artificial intelligence (AI) and
In a world where accountability and transparency are paramount, whistleblowing serves as a powerful tool to combat fraud. Whistleblowers play a crucial role in exposing
Medical billing fraud continues to be a pervasive issue in the healthcare industry, causing significant financial losses and undermining the integrity of patient care. Healthcare
Managed Care Medicare and Medicaid fraud have become pervasive in the United States, costing taxpayers billions of dollars annually. One form of healthcare fraud that
Whistleblowing to expose healthcare fraud is a courageous act that reveals unlawful practices and protects patients from substandard care. However, to be effective, whistleblowers must
Medicare fraud within Assisted Living Facilities across the country. As more facilities take advantage of the system, it’s important to know how to spot the
