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

• $195 AHIP Members
• $240 Non-members

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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 designation:

Health Care Anti-Fraud Associate (HCAFA)
Health Insurance Associate (HIA®)
Dental Benefit Associate (DBA)
Healthcare Customer Service Associate (HCSA)
Managed Healthcare Professional (MHP)