AHIP's Center for Insurance Education and Professional Development - Anti-Fraud
Skip NavigationHealth insurance education is evolving-and the AHIP Center for Insurance Education and Professional Development is changing to meet the training needs of busy professionals. Now with more content online, expanded course offerings-including the Academy of Healthcare Management's course content-the Center is where professionals go to learn the health insurance industry industry. The Center offers self-study classes, publications, workshops, virtual seminars, and designations covering such topics as anti-fraud, business operations, consumer-driven health care, customer service, disability insurance, employee benefits, health insurance fundamentals, HIPAA, long-term care, managed care and care management, Medicare, Medicaid, Medigap, supplemental insurance, underwriting, network management, health plan finance and risk management, governance and regulation, and more.
America's Health
Insurance Plans 		Health insurance education is evolving-and the AHIP Center for Insurance Education and Professional Development is changing to meet the training needs of busy professionals. Now with more content online, expanded course offerings-including the Academy of Healthcare Management's course content-the Center is where professionals go to learn the health insurance industry industry. The Center offers self-study classes, publications, workshops, virtual seminars, and designations covering such topics as anti-fraud, business operations, consumer-driven health care, customer service, disability insurance, employee benefits, health insurance fundamentals, HIPAA, long-term care, managed care and care management, Medicare, Medicaid, Medigap, supplemental insurance, underwriting, network management, health plan finance and risk management, governance and regulation, and more.

Courses - Antifraud

Fraud, Part I (Introduction)
You’ll gain valuable insight from this broad overview of health insurance fraud. This self-study course focuses on investigative methods for detecting fraud and delves into the many areas in which fraud occurs, including fraud and abuse by providers, consumers, agents, and others.

What You’ll Learn:

  • Methods investigators use to uncover and deter fraud perpetrated against the health care and health insurance industries
  • How health insurance fraud schemes work
  • How to identify fraudulent practices in medical expense insurance, managed care, and disability income insurance
  • What legal, regulatory, and compliance issues affect anti-fraud efforts
  • Relevant terms, case scenarios, and key concepts

Who Should take this Course:

  • Employees of health insurance plans and health care organizations
  • Managers and staff working in special investigation units (SIUs)
  • Corporate counsel and legal advisors
  • Compliance and privacy officers
  • Claims analysts
  • Fraud examiners
  • Federal and state regulatory personnel
  • Others in related fields who seek more knowledge in fraud investigation

Enrollment
$155 AHIP Members; $190 Non-members



To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.

Publication
Health Care Fraud: An Introduction to Detection, Investigation, and Prevention
$40 AHIP Members; $50 Non-members

Earn a Designation
This course is good towards earning the following Center designation:

This course also meets the continuing education requirements of the National Health Care Anti-Fraud Association’s (NHCAA) Accredited Health Care Fraud Investigator (AHFI) designation.

Continuing Education Credits

  • The Commission for Case Manager Certification (CCMC) grants 20 contact hours for this course.

For more information about continuing education credits for this course, visit http://ahipce.insurancestudy.com.

Fraud, Part II (Key Products)
This self-study course examines the impact of fraud on a range of insurance products—disability income, life, long-term care, and dental coverage. You’ll become familiar with federal and state roles in combating fraud, explore the private sector, and get an understanding of legal constraints placed on enforcement efforts.

What You’ll Learn:

  • Impact of fraud on a range of insurance products, including disability income, life, long-term care, and dental coverage
  • Specialized health care fraud considerations that must be taken into account when dealing with pharmaceutical, supplemental, and Medigap insurance plans
  • The roles of federal and state government entities in combating health care fraud
  • The role of the private sector in detecting health care fraud and the legal constraints placed upon its enforcement efforts
  • Relevant terms, case scenarios, and key concepts

Who Should take this Course:

  • Employees of health insurance plans and health care organizations
  • Managers and staff working in special investigation units (SIUs)
  • Corporate counsel and legal advisors
  • Compliance officers
  • Claims analysts
  • Fraud examiners
  • Federal and state regulatory personnel
  • Others in related fields who seek more knowledge in fraud investigation

Enrollment
$155 AHIP Members; $190 Non-members



To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.

Publication
Insurance Fraud in Key Products: Disability, Long-Term Care, MedSupp, Drug Coverage, & Others
$40 AHIP Members; $50 Non-members

Earn a Designation
This course is good towards earning the following Center designation:

This course also meets the continuing education requirements of the National Health Care Anti-Fraud Association’s (NHCAA) Accredited Health Care Fraud Investigator (AHFI) designation.

Fraud, Part III (Legal Issues)
Sharpen your skills in combating fraud with this in-depth self-study course exploring public and private enforcement activities. You’ll learn about tools available to government agencies and get an inside look at the legal issues fraud investigators deal with involving compliance and privacy.

What You’ll Learn:

  • The roles of federal and state government in combating health care fraud and the statutes and tools available to these agencies
  • Private sector enforcement activity with an emphasis on legal issues such as compliance and privacy
  • Legal constraints placed upon enforcement efforts
  • How public and private sectors can work together to combat fraud
  • Relevant terms, case scenarios, and key concepts

Who Should take this Course:

  • Employees of health insurance plans and health care organizations
  • Managers and staff working in special investigation units (SIUs)
  • Corporate counsel and legal advisors
  • Compliance and privacy officers
  • Claims analysts
  • Fraud examiners
  • Federal and state regulatory personnel
  • Others in related fields who seek more skills in fraud investigation

Enrollment
$155 AHIP Members; $190 Non-members



To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.

Publication
Legal Issues in Healthcare Fraud and Abuse: Navigating the Uncertainties
David E. Matyas, Esq. and Carrie Valiant, Esq., $139 AHIP Members; $169 Non-members

Earn a Designation
This course is good towards earning the following Center designation:

This course also meets the continuing education requirements of the National Health Care Anti-Fraud Association’s (NHCAA) Accredited Health Care Fraud Investigator (AHFI) designation.
The Center is changing to meet the needs of busy professionals like you. Now with more content online, expanded course offerings-including the Academy of Healthcare Management's course content-as well as other quick, convenient, and flexible ways to learn, the Center is where professionals go to learn the industry. The Center offers educational programs on such topics as anti-fraud, consumer-driven health care, disability insurance, employee benefits, health insurance fundamentals, HIPAA, long-term care, managed care and care management, Medicare, Medicaid, Medigap, supplemental insurance, underwriting health plan finance and risk management, governance and regulation, and more.

Copyright © 2010 America's Health Insurance Plans. All Rights Reserved.