Format: On demand
Duration: 200 Mins
Instructors: Coral MED
Learning Credits: 0.2 CEU
*This course was updated on Jan 01, 1970.
This unit focuses on the practical application of fraud prevention strategies through the design and implementation of comprehensive compliance programs in healthcare organizations. Learners will explore the core components of a successful fraud prevention program, including governance structures, policy frameworks, employee education, monitoring systems, and corrective action planning. The course also integrates the OIG’s Seven Elements of an Effective Compliance Program as the foundation for program development.
Define the essential components of a fraud prevention program in healthcare. Explain the role of training programs and identify key stakeholders in preventing healthcare fraud. Explain the critical steps involved in implementing a comprehensive fraud prevention program in a healthcare organization. Analyze how organizational culture impacts the success of a fraud prevention program. Apply industry best practices to customize and integrate specific fraud prevention measures within a given healthcare organizational context. Evaluate the effectiveness of a fraud prevention program by utilizing relevant metrics, reporting mechanisms, and audit findings. Design a tailored, comprehensive fraud prevention program for a healthcare organization, ensuring alignment with regulatory requirements and organizational goals.
By the end of this unit, learners will be able to: Design a comprehensive fraud prevention program tailored to healthcare organizations. Implement internal controls and reporting mechanisms that support compliance. Facilitate staff training and communication on fraud prevention policies. Measure program success through audits, performance indicators, and risk assessments. Align program implementation with ethical standards and legal requirements.
Completion of Unit 3.4 , Fraud Prevention Laws and Regulations or familiarity with compliance frameworks and legal aspects of fraud prevention.
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Compliance and risk management officers establishing organizational fraud prevention frameworks. Healthcare administrators and executives responsible for program oversight. Auditors, consultants, and policy developers implementing compliance systems. Training and education coordinators delivering compliance learning modules. Students and professionals aspiring to careers in healthcare governance, compliance leadership, or risk management.