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The Role Of Fraud In Health Care

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Health care fraud has been around for quite some time and is increasingly adding problems to the health budget. To aid in the reduction of fraud the “Twin-pillar” approach was one of the strategies implemented. This uses a two-step approach using analytics in a fraud prevention system and a provider screening program to identify ineligible suppliers and providers. Within these levels are others levels for screening risk, however, these approaches that are being implemented causes some potential issues due to conflict of interest between contractors and providers, disincentives for states and having to contribute upfront cost to solve the issues among others. Some of the tools included in spotting out fraud are social networking tools that
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