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Progress in Medical Sciences ISSN: 2577 - 2996
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Video Article

Impact Factor: 1.023*

Progress in Medical Sciences. 2022; 6(6):(157-164)


Fraud Prevention in Healthcare

Anand Laxman Mhatre

Abstract

Healthcare fraud is an evolving problem that fraudulently increases spending for private and public payers. Although the 'pay and chase' model has helped insurers recover some losses, the model is inefficient and incentivizes fraud. Deterrence is an alternative to 'pay and chase' that has demonstrated immense potential in curbing healthcare fraud. The model proactively detects fraud and disincentivizes fraud. This document explored healthcare fraud and how deterrence can be leveraged to mitigate the challenge.