Insurance Fraud and Abuse
Health insurance fraud is a problem globally, and Saudi Arabia is not immune. Assume you have been tasked with presenting this problem to your healthcare organization so employees can act appropriately when processing health insurance claims. Be sure to address:
- Actions that would be considered fraudulent;
- Key indicators that fraud is present;
- The impact of fraud on the medical community, health insurance companies, and Saudi Arabia; and
- How to report health insurance fraud and penalties for those that participate in such behavior.
Your presentation should meet the following structural requirements:
- Be organized, using professional themes and transitions.
- Consist of seven slides, plus the title and reference slides.
- Each slide must provide detailed speaker’s notes—a minimum of 100 words. Notes must draw from and cite relevant reference materials.
- Provide support for your statements on the presentation slides, as well as in the speaker’s notes, with in-text citations from a minimum of four scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the others must be external. The Saudi Digital Library is a good place to find these references.
- Follow APA and Saudi Electronic University writing standards.
Requirements: • Consist of seven slides, plus the title and reference slides. • Each slide must provide detailed speaker’s notes—a minimum of 100 words. Notes must draw from and cite relevant reference materials. | .ppt file
Answer preview
- The Saudi Arabia health insurance industry is full of different types of claim and compensation cases.
- There is a high number of fraudulent cases.
- This affects the customers, the health insurance organizations, the local and the national government.
- The Saudi Arabia health insurance represents more than 51% of the insurance industry.
- More than 9 million citizens registered in the Cooperative Council for Health Insurance (CCHI).
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