Unfortunately, according to a recent report by the Association of Certified Fraud Examiners (ACFE), companies are estimated to lose 6% of their annual revenues to occupational fraud (Maas, 54).
"… It's a perfect crime; from needles to bandages to lab tests and claims processing, the healthcare industry is awash with an extraordinarily high volume of products, services, and transactions moving through different organizations on a monthly basis … the type of health care billing schemes someone can initiate is only limited by their imagination," according to Christopher Nickell, a leading fraud auditor and healthcare expert. "…A recent audit of three small, rural-based healthcare organizations consisting of (1) a third-party administrator, (2) a primary care physician practice and (3) an outpatient rehabilitation center found them to have a combined total of 628 vendors on file with a one-month disbursement totaling 1,447 payment transactions for goods and services" (Hast, 1).
From pencils and paper to medical supplies, equipment, and other miscellaneous items, the list can be extensive and exhaustive. Thus, one can clearly see how this creates an appetite for fraud, which constitutes a staggering amount of losses for healthcare organizations. "… Fraud will always occur where motive and opportunity exist. Health Care Fraud.
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