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Introduction to Dental Fraud

A Comprehensive Guide to Investigating False Claims

This is the only training textbook of its kind on how to identify, investigate, report & prosecute cases of suspected dental fraud. Defend against false & fraudulent claims by setting up an effective, proactive anti-fraud program.

Introduction to Dental Fraud, published by the California Investigative Academy, provides field proven techniques for identifying, investigating, prosecuting and defending against dental fraud. This text provides a detailed, in-depth, and comprehensive approach to what is unquestionably the most powerful tool in the fight against insurance fraud - the investigative medical audit.

View the table of contents to get an idea of the topics covered in this cutting edge training tool.

Written by Eric Tackett
Published by the California Investigative Academy
$29.95 - Comb bound soft cover

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Table of Contents

Chapter One -- What is Fraud?
The Criminal Statutes
The Civil Statutes
False Claims vs. Fraudulent Claims
Other Dental Related Healthcare Crimes
The Cost of Fraud

Chapter Two -- The Nature of Dental Fraud
Who Commits Dental Fraud?
Dental Fraud Schemes
Red Flags: Identifying Dental Fraud
What is a "Red Flag"
Identifying Red Flags

Chapter Three Referring/Reporting Requirements
Referring/Reporting Requirements
What Should Be Referred and What Should Not
To Whom Should Suspected Fraud Be Reported?
Sources of Referrals
Appropriate Forms of Reporting Fraud

Chapter Four Investigating Dental Fraud
The Investigative Process
Preliminary Evaluations
Interviewing & Statement Taking
Provider Investigations
Collecting & Preserving Evidence

Chapter Five Defending Against Dental Fraud
Establishing an Effective Anti-Fraud Program
Acquiring the Tools of an Effective Program
The Federal False Claims Act
The California False Claims Act

Chapter Six The Process of Prosecution
Referring Cases for Criminal Prosecution
The "Documented SFC" Package


 

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