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Session Information

AALNC 2008 National Educational Conference

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332: Healthcare Fraud in the Emerging E-Health World

Track : LNC Nursing issues

Program Code: 332

Date: Thursday, April 10, 2008

Time: 1:15 PM to 2:30 PM EST

Location: Meeting Room 5-6

SPEAKER :

Rebecca Busch, RN MBA CCM CFE FHFMA, MBA Inc.

80+ publications/presentations, 20+ years of progressive achievement in the health care management industry. Rebecca Busch is a pioneer in conducting technology and process-enabled audits of health care claims & processing. She developed proprietary data analysis tools and currently has a patent pending on a data anomaly profiler. She is a registered nurse and an MBA as well as a certified fraud examiner (CFE), health care fellow in financial management (FHFMA) and internal auditor (formal CIA accreditation pending). In 1991 Rebecca founded Medical Business Associates with the vision of delivering a multi-disciplined approach to conducting comprehensive audits for Major Employers, Hospitals and Insurance Companies. Her proprietary methodology employs statistical analysis of claims and procedural data -- specifically targeted to identifying the most probable areas of operational breakdowns, exposure to fraud, financial errors, and cost savings. Ms. Busch�s ability to quickly identify anomalies from vast amounts of data has distinguished her and Medical Business Associates as an invaluable source of dramatic cost-savings for clients. Ms. Busch currently has a patent pending in the area of medical and financial errors in health care; has testified as an expert in the area of health care reimbursement, internal controls, life care expense analysis, patient care documentation and respective damages and she has authored, healthcare fraud audit and detection guide, Wiley Publications available after October 2007 and a how to book that will teach American families how to detect fraud in reviewing their own families medical bills. Additionally she is a faculty member of the Association of Certified Fraud Examiners who has published numerous articles and is a frequent public speaker.

Description

Learning Objectives:

1. Describe common indicators of fraud and abuse.

2. Define practical applications of skills used to detect fraud and abuse.

This session will discuss emerging themes for an LNC to be aware of in an eHealth world. Topics will include how fraud and abuse materialize in health records in the provider setting, payer setting and employer setting. Ms. Busch will discuss an overview of fraud and abuse and how to look for it, and will define practical applications of fraud and abuse in its detection.

Audio Synchronized to PowerPoint

(Code: 332)

List Price:

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This session is a part of:

CON2: Main Conference Session Compilation Access

CON: Full Access to All Sessions
(52.16 Nursing Contact Hours Available*; 56 Case Manager Certified Contact Hours Available*)
Conference attendees may only earn and claim nursing contact hours for those sessions that were not attended onsite in Tampa."

LNC Nursing issues Track (Attendees - $70 - Non-Attendees $140)

Handout / Test Questions

(Code: 332)

Regular Attendee: Free

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