Stopping fraud.

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This is a review of the 2011 article, “Stopping Fraud”, by Lisa A. Eramo.

Introduction

Fraud continues to be an issue that is going primarily undetected when it comes to Healthcare, especially with Electronic Healthcare Records (EHRs). Despite costing billions of dollars a year, very few cases of electronic healthcare fraud have been detected and those cases that are detected are usually not detected until after years of fraud have been committed. Although the Obama administration has provided financial support to the Health Care Fraud and Abuse Control Program, stopping fraud will require organizations and individuals capable and committed to detecting and stopping it. With a review of the most common type of fraud when it comes to electronic healthcare, this article identifies ways to that can be utilized to minimize fraud from occurring.

Most common type of Electronic Healthcare Fraud

False Claims is one of two of the most common types of E Health and leads to the other most common type of fraud, financial fraud. False claims, which includes unnecessary services and services never completed on claimed patients, along with financial fraud is a 250 billion dollar problem in today’s healthcare.

Stopping and preventing Fraud

In a technologically advanced society such as the one we live in, fraud and crime are inevitable, but there are many ways in which healthcare organizations and physicians can help minimize and prevent from happening to them. Stopping Fraud recommends a number of methods that can be utilized to help minimize and prevent E Health fraud. The first of these is user authentication both the patient being seen and the clinician seeing the patient. Biometrics such as the fingerprints and iris scans are amongst the many forms of user authentication technology available. In addition to user authentication, audit trails are also recommended with date and time stamps on each entry into patients EHR. Additionally organizations and E Health users can stay up to date with rules and regulations, utilize computer assisted coding, participate in fraud and abuse committees, and educate. [1]

Comments

The more and more I research Healthcare fraud, the more apparent it is that it is commonly overlooked, making it lucrative for individuals to commit. In this article, William Rudman stated that we are probably only at the tip of the iceberg in terms of being able to identify and understand fraud, and I have to completely agree. In my opinion, we are going to be looking into fraud well after it has been committed as mentioned in this article until we as professionals take a stand to fight it before it happens. In order to fight fraud from the front, we are going to need to educate not only system users, but also everyone within our organizations and offices. While education will not prevent fraud from happening, it will make us more aware of our surroundings and able to identify it if we see it.

References

  1. Eramo 2011. Stopping fraud. http://search.proquest.com.ezproxyhost.library.tmc.edu/docview/852762032?pq-origsite=summon&accountid=7034