FOR NYANYA (ONLY) – Week 5 Discussion Questions

Week 5 DQ


Required Resources:

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ISBN: 978-0-07-351371-3

Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance, an Integrated Claims Process Approach. (6th Ed.), New York, NY: McGraw-Hill Publishers.

  • Chapter 15
  • Chapter 16

ISBN: 978-0-7637-5964-3

Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance Workbook. New York, NY: McGraw-Hill Publishers.


Week 5 Discussion:


The Office of the Inspector General, acting in its capacity to combat fraud and abuse, can initiate audit investigations of health insurers as well as health providers. As a professional, you need to be aware of situations that can result in an audit and how healthcare professionals can reduce the probability of an audit.

To Prepare for the Assignment:

With these thoughts in mind:

Post your primary response to DQ1 by Day 3: Choose one (1) example of criteria that might be reviewed by the Office of the Inspector General. Then provide 2-3 ways to prevent any audit concerns. Finally, suggest how your current or future role in healthcare might be able to prevent an audit concern.

Instructions for post: Title of post: Your Name, Audit Concern


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