Introduction
Health care costs are a top concern for both businesses and individuals. Health care companies and providers today face unique industry regulations, procedures and considerations, as well as a heightened potential for fraudulent activity. Consequently, fraud fighters need an in-depth understanding of the industry environment and the types of health care fraud that can occur, including how to prevent, detect and investigate them.
This course is designed for anti-fraud and audit professionals who work in the payer, provider, vendor and employer benefit areas or advise clients who operate within the health care continuum. Get the targeted training you need to keep up with the latest fraud schemes and related laws affecting this highly complex profession.
Duration
5 Days
Who Should Attend
- Health Medical underwriters, claims officers.
- Accountants, auditors, attorneys and investigators who service health care industry clients
- Detectives and private investigators
- Government investigators charged with identifying fraud or noncompliance with government-funded health care facilities and efforts
- Internal auditors for hospitals, medical offices and other health care organizations
- Public-sector investigators
- Anti-fraud professionals
Course Level:
Course Objectives
- Navigate the complex payment systems in the Kenyan health care industry
- Identify the common health care schemes committed by providers, beneficiaries and third parties
- Categorize health care violations under the legal enforcement framework
- Conduct a health care fraud investigation
- Develop fraud prevention procedures specific to the health care industry
Course Outline
- Complex payment systems in the Kenyan health care industry
- Common health care schemes committed by providers, beneficiaries and third parties
- Health care violations under the legal enforcement framework
- Conducting a health care fraud investigation
- Developing fraud prevention procedures specific to the health care industry
Related Courses
Course Administration Details:
Methodology
These instructor-led training sessions are delivered using a blended learning approach and include presentations, guided practical exercises, web-based tutorials, and group work. Our facilitators are seasoned industry experts with years of experience as professionals and trainers in these fields. All facilitation and course materials are offered in English. Participants should be reasonably proficient in the language.
Accreditation
Upon successful completion of this training, participants will be issued an Indepth Research Institute (IRES) certificate certified by the National Industrial Training Authority (NITA).
Training Venue
The training will be held at IRES Training Centre. The course fee covers the course tuition, training materials, two break refreshments, and lunch. All participants will additionally cater to their travel expenses, visa application, insurance, and other personal expenses.
Accommodation and Airport Transfer
Accommodation and Airport Transfer are arranged upon request. For reservations contact the Training Officer.
- Email: [email protected]
- Phone: +254715 077 817
Tailor-Made
This training can also be customized to suit the needs of your institution upon request. You can have it delivered in our IRES Training Centre or at a convenient location. For further inquiries, please contact us on:
- Email: [email protected]
- Phone: +254715 077 817
Payment
Payment should be transferred to the IRES account through a bank on or before the start of the course. Send proof of payment to [email protected]
Click here to register for this course.
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