Monday, May 25, 2020

What Is Healthcare Fraud - 1990 Words

What is healthcare fraud? Healthcare fraud is a criminal behavior, in which a person files a false claim, with the purpose of reimbursement. Healthcare abuse is similar, but focuses more on practices that do not match up with accepted solid financial, business, or medical practices, thus resulting in an avoidable cost or repayment for services that are not needed, or that fail to meet professionally familiar values for healthcare (Johns Hopkins, n.d.). While these both may have very different definitions, they are fall under the category of healthcare fraud and are both punishable by law when convicted. Healthcare fraud may be something as simple as a doctor over billing the insurance for only a few dollars, all the way on up to†¦show more content†¦Restitution is another factor when convicting these criminals. Criminals convicted of healthcare fraud can pay restitution from hundreds, to multiple thousands of dollars, depending on the crime committed and the money impro perly obtained as a result of their criminal behavior. Probation is another punishment that the judge may impose on the offender. Probation will limit the offender’s freedom, once released from the criminal justice system. Probation lasts at least twelve months (Criminal Defense Lawyer, 2017). As stated earlier, healthcare crimes can be something small or on the larger scale, but in the end, the result is the same, it is illegal and it will be punished, as has been shown here. Now that we have looked at the basic facts surrounding this horrific crime, let’s take a look at who is affected and a few different examples of healthcare fraud, to put this all into perspective. Medicaid and Medicare programs began in the 1960’s. While Medicare would constitute the Federal level, Medicaid falls within the state level and are vastly different entities. One article touched on the different areas of Medicaid fraud conducted by physicians. Research has shown that off enders will more than likely offend in multiple areas, instead of focusing on one specific area, to hopefully deter them from being caught (Payne Grey, 2001). Some of these areas may include one or more of the following areas. First is fee for service reimbursement which is whenShow MoreRelatedHealthcare Fraud and Abuse1065 Words   |  5 PagesHealthcare Fraud and Abuse As we head into the next four years under the Obama administration, many Americans are hearing more and more about healthcare reform and what needs to be done to fix the ailing healthcare system. Part of the dramatic increase in healthcare costs is due to Medicare fraud abuse. Healthcare fraud is defined as making false statements or representations of material facts in order to obtain benefits or payment. Healthcare abuse is defined as practices involving the overuseRead MoreThe Issue Of Healthcare Fraud And Abuse1598 Words   |  7 Pagespurpose of this paper is to bring awareness to the issue of healthcare fraud and abuse. I feel that healthcare fraud and abuse is one of the biggest issues in healthcare. So, this paper will get everyone to be able to spot fraud before it happens. During, the process you will be able to identify what a person organization did that was fraud or how they abused healthcare rules. This paper will explain to you what exactly healthcare fraud and abuse is and how it affects everyone around us. ThroughoutRead MoreThe Billing Of Billing Medicare1587 Words   |  7 Pagesnot rendered for are often done as a way of billing Medicare for things or services, that basically never occurred. This can involve forging the signature of those enrolled in Medicare or Medicaid, and the use of bribes or as Healthcare calls it, kickbacks to corrupt healthcare professionals. Upcoding of services is the act of billing Medicare programs for services that are more costly than the actual procedure that was done. Upcoding of items is also very similar to upcoding of services, but it involvesRead MoreThe United States : A Multibillion Dollar Industry1370 Words   |  6 PagesHealthcare in the United States is a multibillion-dollar industry. Over time, the number of elderly people which have fallen victim to Medicare and Medicaid billing fraud has sky rocketed at an alarming rate. The Elder Abuse Nursing Home Neglect Attorneys refer to this as an â₠¬Å"overbilling epidemic† (n.d.). This means that many elders are being charged more money for the services they are receiving or in some circumstances, paying healthcare providers without receiving any care. Since most of themRead MoreFinancial Issues For The Health Care System Of The United States1519 Words   |  7 PagesBackground Pozgar (2012) defines healthcare fraud as an unlawful act, which purpose is for personal gain through deception. It consists of a vast number of illegal acts and irregularities resulting from intentional deceptions. It is no surprise that healthcare fraud is difficult to combat and causes extensive financial issues for the health care system of the United States. This brings us to define what fraud is and how it relates to healthcare. Fraud generally defined as knowingly and willfullyRead MoreMedicare Fraud Essay988 Words   |  4 Pagesand the Department of Justice work to reduce healthcare fraud and investigate dishonest providers and suppliers. The Health Care Fraud Prevention and Enforcement Action Team recouped almost 3 billion in fraud, this year alone. Also, aggressive strategies exist to eliminate Medicare prescription fraud. Patients abusing or selling painkillers received by visiting several doctors and obtaining multiple prescriptions costs Medicare millions annually. Fraud affects everyone, preventing it requires governmentRead MoreMedical Fraud And The United States1004 Words   |  5 Pages Medical fraud and abuse is a huge contributing factor in the rise of healthcare costs in the United States. Although there are many definitions of fraud and abuse, according to Cigna and HIPPA, medical fraud is when there is false representation of a substance, device or a therapeutic system as a way of being beneficial in treating a medical condition, diagnosing a disease, or maintaining a state of health. Medical Abuse is defined ‘as any action that intentionally harms or injures another person’Read MoreHealth Care Fraud Enforcement Arsenal1509 Words   |  7 Pagesissue that many healthcare administrators seem to miss these days is what is currently happening behind the scenes when their hospital’s doctors are filing claims. This issue is very important to address considering your healthcare staff could be filing claims illegally to the Center for Medicaid and Medicare (CMS), and be subjected to the False Claims Act (FCA). Administrators need to make sure clai ms are filed correctly and not for the benefit of the doctors own pocket. Healthcare providers needRead MoreFraud, Abuse, and Waste1211 Words   |  5 Pages Fraud, Abuse, and Waste in the US Healthcare System Tony Hackman University of Phoenix Financial Management in Health Care HCS/577 Adam Craft August 01, 2010 Fraud, Abuse, and Waste in the US Healthcare System Healthcare insurance costs have risen at the average rate of three percent over the inflation rate for the past 10 years. As a result, the government is spending a larger percentage of GDP on healthcare for Americans. One of the reasons for this increase in the overall cost for

Friday, May 15, 2020

Funny Trick or Treat Sayings to Bring Giggles With the Chills

The night of Halloween brings with it a lot of funny stories and anecdotes. The best part of the night is  sitting  together with friends  and sharing candies, and Halloween stories. Some memories fill the house with peals of laughter, while others remind you why Halloween is the  favorite holiday for kids. Kristen Bell: I have friends who wear Star Wars costumes and act like the characters all day. I may not be that deep into it, but there’s something great about loving what you love and not caring if it’s unpopular. Bart Simpson: Trick or Treat isnt just some phrase you chant mindlessly like The Lords Prayer. Its an oral contract. Rita Rudner: Halloween was confusing. All my life my parents said, Never take candy from strangers. And then they dressed me up and said, Go beg for it. I didn’t know what to do! I’d knock on people’s doors and go, Trick or treat. No thank you. Douglas Coupland: Who made the rule that everybody has to dress like sheep 364 days of the year? Think of all the people you’d meet if they were in costume every day. People would be so much easier to talk to – like talking to dogs. Dave Barry: I preferred to trick-or-treat as a vampire, which I felt was much scarier. The problem was the plastic vampire teeth. I have a powerful gag reflex, so when people opened their doors, instead of being terrified by the awesome bone-chilling specter of the Prince of Darkness, theyd see this short,  caped  person, retching. Their only terror was that I might throw up on their shoes. Poorly aligned eye holes are an ancient Halloween, tradition dating back to at least my childhood. My early Halloween memories consist of staggering around disguised as a ghost, unable to see anything but bed sheet, and consequently bonking into trees or falling into brooks. The highlight of my ghost career came in the 1954 Halloween parade when I marched directly into the butt of a horse. So when I open the door on Halloween, I am confronted by three or four imaginary heroes, such as G.I. Joe, Conan the Barbarian and Oliver North, who would look  very terrifying  except that they are three feet tall and facing in random directions. They stand there silently for several seconds before an adult voice hisses from the darkness behind them: Say ‘Trick or treat!’ Conan O’Brien: This Halloween the most popular mask is the Arnold Schwarzenegger mask. And the best part? With a mouth full of candy you will sound just like him. Robert Brault: I don’t know that there are real ghosts and goblins, But there are always more trick-or-treaters than neighborhood kids. Anonymous: The older you get, the harder it is to find someone willing to share a horse costume with you. Emily Luchetti: After eating chocolate you feel godlike, as though you can conquer enemies, lead armies, entice lovers. Hocus PocusWinifred Sanderson from : You know, I’ve always wanted a child. And now I think I’ll have one... on toast! R. L. Stine: When I was a kid my family was really poor and I remember one Halloween I wanted to dress up really scary and my parents came home with a duck costume. I wore that costume for years! I hated it. Jean Baudrillard: There is nothing funny about Halloween. This sarcastic festival reflects, rather, an infernal demand for revenge by children on the adult world. Charlie Brown: I got a rock. Michael Trevino: I only eat candy on Halloween. No lie. Gavin DeGraw: When I was a kid I got busted for throwing a rock through a car window and egging a house on Halloween. Derrick Rose: On Halloween, dont you know back when you were little, your mom tells you dont eat any candy until she checks it? I used to be so tempted to eat my candy on the way to other peoples houses. That used to be such a tease.

Wednesday, May 6, 2020

Diabetes An Autoimmune Disease - 927 Words

It is not news to anyone that one of the most known disease in the world is diabetes mellitus, people with type two diabetes produces some insulin, but not enough to keep their blood sugar at a normal level, however the one that are affected by the type 1 diabetes or childhood-onset type 1 DM do not produce insulin at all. Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. (ADA, 2015) . That circumstance puts them at greater risk for heart disease, renal disease and blindness to name a few. Sadly Worldwide, the occurrence of type 1 DM has been steadily rising, representing a significant burden on the people and to the health-care systems. Although momentous improvements in the care of T1DM patients, a subsection remain in major difficulty due to stubborn hypoglycemia. The possibility of IT offers the chance of better glycemic mechanism. Currently we are observing considerable advancement in the number and results of IT ph enomenal. In type 1 DM is an autoimmune disease that causes the body the destruct the b cells in the pancreas, which are responsible for the production of insulin. As a result, supplementation of insulin is a must in the management of the disease through meticulous care of multiple daily injections to control blood glucose. Even accommodating to the treatment many do not maintain a stable blood glucose level and are at risk for metabolic problems. Ultimately replacing of ÃŽ ² cells are the onlyShow MoreRelatedDiabetes : An Autoimmune Disease Essay1781 Words   |  8 PagesType One Diabetes, Juvenile Diabetes, or Diabetes Mellitus; an autoimmune disease affecting millions (about 3 million in the United States) causes the body’s own immune system to target and attack beta islet cells in the pancreas which are responsible for the production of insulin, an enzyme that lowers the concentration of glucose in the blood. A century ago, diabetes was a quick death sentence; we only fo und how to produce artificial insulin in the 1920’s, so before that, if a patient got diabetesRead MoreDiabetes : An Autoimmune Disease1430 Words   |  6 Pages What is Diabetes? Diabetes affects approximately 6% of Americans, 17 million people, and alarmingly 5.9 million of them are unaware that they have this chronic disease. Diabetes is a disease that is classified into two central types, type 1 and type 2. The disease results in the body being incapable of producing enough insulin and also causes an inability to use the insulin that has produced. Type 1 diabetes is considered to be an autoimmune disease that has the ability to destroy the facilityRead MoreFood Diabetes : An Autoimmune Disease1035 Words   |  5 PagesFood Diabetes In this paper, I would be talking about food diabetes. I would be talking about the difference between type 1 and type 2. Also, foods that you can eat and that you can’t. Finally, the history of food diabetes and how it affects people’s body. Food diabetes sometimes, leads to bad things. I. Food diabetes is a lifelong chronic disorder in which there are high levels of sugar in the blood. Hesy-Ra, an Egyptian physician, discovered food diabetes around 1152 B.C. The American DiabetesRead MoreDiabetes Mellitus : An Autoimmune Disease1238 Words   |  5 Pages Diabetes or as doctors would refer by as diabetes mellitus, is a group of metabolic diseases in which a person has a high blood glucose level (above 110 mg/dL) because insulin production is inadequate, the body’s cells do not respond properly to insulin or even both. Diabetes mellitus is also a contributing factor of development of cardiovascular disease, hypertension, renal failure, blindness, and stroke as individuals’ age. There are 3 different types of diabetes mellitus, type 1diabetes mellitusRead MoreDiabetes Mellitus : An Autoimmune Disease1914 Words   |  8 Pagesissues. Autoimmune diseases like Type 1 diabetes mellitus affect adults as well as children. In children diabetes requires a lot of attention and demands a lot to maintain proper care and regulation of medications. There are many medications that Type 1 diabetes mellitus can be regulated with along with other treatments to prevent a downward effect of issues that diabetes mellitus causes. Type 1 diabetes mellitus affects mainly children and statistics have proven that this particular autoimmune diseaseRead MoreDiabetes Mellitus : An Autoimmune Disease1261 Words   |  6 PagesDiabetes or as doctors would refer by as diabetes mellitus, is a group of metabolic diseases in which a person has a high blood glucose level above 110 mg/dL because insulin production is inadequate, the body’s cells do not respond properly to insulin or even both. Diabetes mellitus is also a contributing factor of development of cardiovascular disease, hypertension, renal failure, blindness, and stroke as individuals’ age. There are 3 different types of diabetes mellitus, type 1diabetes mellitusRead MoreType 1 Diabetes : An Autoimmune Disease1741 Words   |  7 PagesType 1 diabetes is an autoimmune disease that destroys beta cells, beta cells produce insulin in the the pancreas. When beta cells are destroyed It leads to lack of insulin, insulin lowers blood sugar (glucose). When immune system cells are seen it can also cause a viral infection. Type 1 diabetes is more commonly diagnosed in children and young adults, diabetes type 1 also known as juvenile diabetes. Insulin is a hormone that is needed to convert sugar, protein, and carbohydrates for energy Read MoreCoexistence of Autoimmune Disease with Type I Diabetes Mellitus in Libyan Patients2041 Words   |  8 Pagesthe patients files, the concomitant disease presence or absence was also recorded; especially with reference thyroid function. The important investigations as prescribed by the physician were also recorded. patient’s serum level of T4, T3, FT4, FT3 and TSH were measured for 748 patients. The venous blood samples were taken from all the subjects in the morning after fasting overnight while TPOAb and TGAb level were measured abroad. 101 of patients with type1 diabetes mellitus were included in this studyRead MoreDiabetes Mellitus : An Autoimmune Disease And Affects The Body s Metabolism Of Carbohydrates1316 Words   |  6 Pages Carla Rodriguez MED 2056 Diabetes Mellitus Instructor Anglo March 11, 2015 Pathophysiology Diabetes mellitus is an autoimmune disease and affects the body’s metabolism of carbohydrates. There are varying types of diabetes but patients are predominantly diagnosed with type 1 or 2. Type 1 is an insulin dependent diabetes mellitus and type 2 is a non-insulin dependent diabetes mellitus. Patients are tested for diabetes by undergoing blood sugar tests or urinalysis. Typical symptomsRead MoreEssay about The Hygiene Hypothesis1083 Words   |  5 Pageshygiene hypothesis states that although we have shifted rapidly into a clean, modern and civilized state, our bodies have not yet adapted, and our immune system is responding inappropriately with an increased susceptibility to allergies and autoimmune diseases. The main premise is that humans are mismatched to modernity. (Stearns, 2009) Our civilization has changed rapidly and we now readily have access to modern hygiene, clean water, and antibiotics but our bodies have not yet evolved to adapt

Tuesday, May 5, 2020

Lead Participate Collaboratively In A Team â€Myassignmenthelp.Com

Question: Discuss About The Lead Participate Collaboratively In A Team? Answer: Introducation During this lesson, I learned that teams are relied upon to produce results. However, execution is frustrated when colleagues don't function admirably together. A common group condition is fundamental to the team's success. A group is characterized as a gathering of individuals cooperating toward a shared objective. Without a target, there is no group. Thoughts for marketing a common purpose incorporate: Creating as well as surveying the group's charter. Discussing why the group exists. Allowing each colleague to express their commitment. Creating mottoes, images, honors, or notices that depict the group as one unit. Use the official reason to organize group activities. As a team leader, I identified the main aspects in a group that requires critical attention. Colleagues must believe each other if they are to cooperate effectively. Thoughts for building trust among colleagues include: Being honest and working to eradicate irreconcilable situations. Besides, abstain from talking behind each other's back and trust partners. I should believe them before they will trust me. Giving members the opportunity to be vindicated. Additionally, knowing everybody's part and being acquainted with the obligation of those elements make effectiveness and adaptability (Cannon-Bowers, and Salas, 2007). Ideas for illuminating parts of the group include: Review colleagues' parts frequently and relate colleague desires to the group's general purpose. Clarifying duties when activity planning. Learning what others do on the team and figuring out approaches to enable each other. Thirdly, Miscommunication to can make hard sentiments and undermine the achievement of the group . For instance, error in favor of over communicating, trying to see all angles and Working to clear up mistaken assumptions rapidly and accurately. Also, Reinforcing and perceiving colleague endeavors (Nancarrow et al. 2013). As a team leader, I identified some skills that relate to teamwork. First, I am equipped with conflict solving skills. It involves determining and respecting each sides point of view then identifying the area of conflict (Pinto, and Kharbanda, 2005). As such I have solved various problems among team members as well as giving insights on how to avoid future conflicts. Colleagues originate from varying backgrounds, with different foundations and points of view. It is, therefore, important to keep in mind that individuals can and do contrast with each other (Donnellon, 2006). Team members should attempt to learn as much as you can from others. Besides, keeping away from comments that attract antagonistic thoughtfulness regarding a man's one of a kind attributes and trying not to disregard the distinctions among colleagues (Stewart, and Sims, 2009). However, from experience working as a team and more so as a team leader can be challenging. One of the challenges faced was trying to give instructions to a member who is older by age. The problem is that this particular colleague disliked taking orders from me as I was younger than him. Nonetheless, as I was chosen team leader, I explained to the teammate that what he had done was disrespectful. However, the issue was handled amicably. Demonstrate critical self-review, self-management, and lifelong learning. As a person who wishes to follow a career in engineering, I believe there are some behaviors that I need to change. First, time management. I have realized that my time management is abysmal. It is an issue that has been pointed out by colleagues and my supervisor. Upon self-reflection, I have realized that keeping time and meeting deadlines are some of the things that I have been lagging behind in (Britton, and Tesser, 2011). I need to change my procrastination behavior by ensuring the tasks are completed before the deadline. I realize that time management is necessary for my career, as well as while working in a team. Secondly, I can be quite indecisive. As a team leader, this had always been a challenge, though a different team member was always able to complement. I realize that decision-making is an important skill that works towards achieving goals promptly. I need to become more decisive by making decisions based on the adequate information available on the situation. Addition ally, my lighthearted indifference has been pointed out as a tendency that shows lack of precision and commitment. As such, becoming a better timekeeper and decisive should aid in my career. Time management is one of my poor qualities. Time and again it has been pointed out to me that this behavior would cost me projects and business relationships if I did not correct it. Meeting deadlines is a significant issue in time management. I have a habit of procrastination that always leads to lack of meeting deadlines. As such, with my poor time management, it could result in delays in projects, costing more money to my clients and eventually ruining prospect business relations. Though I always arrive at my workplace in time, task completion is my worst time management. I either take longer than average time taken to complete a task, or I tend to postpone some activities. It leads to accumulation of works that could eventually affect my efficiency at the workplace (Trueman, and Hartley, 2006). I have been working on my career plan. Though some details still require refining as I work towards attaining my career goals, most aspects have been organized. First I would wish to work in Chess engineering PTY Ltd. I believe that the corporation is equipped with different structural and civil engineering resources that would enable me to acquire various skills in engineering. In the future, I would also like to start my engineering company. Despite my engineering focus, I would wish to learn an assortment of skills that relate to all areas of engineering as well as organization competencies (Chess Engineering. 2017). I intend to obtain these aptitudes through apprenticeship and school learning. References Britton, B.K., and Tesser, A., 2011. Effects of time-management practices on college grades. Journal of educational psychology, 83(3), p.405. Cannon-Bowers, J.A., and Salas, E., 2007. Teamwork competencies: The interaction of team member knowledge, skills, and attitudes. Workforce Readiness: Competencies and assessment, pp.151-174. Chess Engineering. 2017. Australian Engineering Specialists | Chess Industries. [online] Available at: https://www.chessindustries.com.au/ [Accessed 14 Sep. 2017]. Donnellon, A., 2006. Team talk: The power of language in team dynamics (No. 04; e-book.). Nancarrow, S.A., Booth, A., Ariss, S., Smith, T., Enderby, P. and Roots, A., 2013. Ten principles of good interdisciplinary teamwork. Human resources for Health, 11(1), p.19. Pinto, J.K., and Kharbanda, O.P., 2005. Successful project management: leading your team to success. Van Nostrand Reinhold. Stewart, G.L.M. and Sims, C.C., 2009. Team work and group dynamics (No. 658.4036 S8). Trueman, M. and Hartley, J., 2006. A comparison between the time-management skills and academic performance of mature and traditional-entry university students. Higher education, 32(2), pp.199-215.