Healthcare fraud is a type of white-collar crime that involves the filling of dishonest healthcare claims in order to turn a profit. Fraudulent healthcare offenses come in many forms. The healthcare provider faces incarceration, fines, and possibly losing the right to practice in the medical industry, whilst members can be blacklisted and fail to join any other Medical Aid Society.
Healthcare Funders and services providers today face unique industry regulations, procedures and considerations, as well as a heightened potential for fraudulent activity. Consequently, fraud fighters need an in-depth understanding of the industry environment and the types of health care fraud that can occur, including how to , detect, investigate and prevent them.