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Health Care-Related Fraud Prevention: Part One of Two
Financial Services
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Health Care-Related Fraud Prevention: Part One of Two
September 6, 2018
by Diana K.W. Treated, MD, MPH
Health care fraud is a continuing problem in the United States, with annual payments for health care-related fraud exceeding $16 billion in 2017.1,2 Most health care-related fraud occurs in the emergency room, where it can be difficult to identify the primary cause of a patient’s condition. This is why it is important to establish a consistent and robust approach to patient identification.
Emergency rooms and critical care units have unique challenges when it comes to patient identification. They are not typically part of the emergency response system in hospitals, and for them to be identified as such, they need to establish an individual patient record with the hospital’s admitting, transfer, and emergency room departments. In order to develop such an individual patient record, it is important to clearly establish who a patient is, why they are presenting to the emergency room, and what is wrong with them.
A first step in creating this type of patient record is understanding who a patient is. At the most basic level, this is establishing a patient’s name, a patient’s date of birth, be359ba680
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