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One of the many certifications that ANCC offers is a Case Management Nurse Certification. Registered nurses who successfully pass ANCC's Case Management Nurse exam [10] are entitled to use the credential, RN-BC (Registered Nurse - Board Certified).
An overpayment scam, also known as a refund scam, is a type of confidence trick designed to prey upon victims' good faith.In the most basic form, an overpayment scam consists of a scammer claiming, falsely, to have sent a victim an excess amount of money.
Learn how to recognize a merchant services scam and prevent payment fraud while protecting your business and customers.
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging ...
Theft or bribery concerning programs receiving federal funds (sometimes referred to as program fraud or program bribery) is a federal crime under 18 U.S.C. § 666. The purpose of this statute is protect the integrity of the vast sums of money distributed through federal programs. The section is designed to facilitate the prosecution of persons ...
Insurance fraud includes a wide variety of schemes in which insureds attempt to defraud their own insurance carriers, but when the victim is a private individual, the con artist tricks the mark into damaging, for example, the con artist's car, or injuring the con artist, in a manner that the con artist can later exaggerate.
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
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