While working at the medical office where you are a reimbursement specialist, you notice that a Medicare patient has many more laboratory tests done than a non-Medicare patient. Consider these questions in your initial post to the Discussion Board.
• What is the difference between fraud and abuse?
• Could this be a case of fraud or abuse? Why or why not?
• Is it appropriate to notify your office manager?
• How would you go about investigating this particular case? What would you review? How would you proceed?
• What is the impact of having fraud and abuse occur at your facility?
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