Medical Plan Forensics
Examining the Evidence
This book is designed to provide the investigative tools and insight in dissecting a Medical Plan on a micro level.
The investigative tools are utilized for the dissection of Self Funded Medical Plans and provides the applications for dissecting Fully Insured Medical Plans. Fully insured plans are owned by the insurance company. Self funded plans with or without Stoploss are owned by the plan sponsor.
It is important when utilizing the investigative tools that the Forensic Examiner remain completely objective in making an accurate determination of the facts involved and the presentation of the facts in a written report. Subjective interpretations and personal opinions must be held back and utilization of objective facts should be the road map utilized in the investigative process.
Contained within the pages of this book is the process of gathering the facts, utilizing tools to validate or invalidate the information, providing the Forensic Practitioner with the processes in a methodical and precise structure to investigate the information and the presentation of the objective findings.
Medical Plan Forensics
Examining the Evidence
This book is designed to provide the investigative tools and insight in dissecting a Medical Plan on a micro level.
The investigative tools are utilized for the dissection of Self Funded Medical Plans and provides the applications for dissecting Fully Insured Medical Plans. Fully insured plans are owned by the insurance company. Self funded plans with or without Stoploss are owned by the plan sponsor.
It is important when utilizing the investigative tools that the Forensic Examiner remain completely objective in making an accurate determination of the facts involved and the presentation of the facts in a written report. Subjective interpretations and personal opinions must be held back and utilization of objective facts should be the road map utilized in the investigative process.
Contained within the pages of this book is the process of gathering the facts, utilizing tools to validate or invalidate the information, providing the Forensic Practitioner with the processes in a methodical and precise structure to investigate the information and the presentation of the objective findings.