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Gwinnett Managed Care, Inc. A Physician Hospital Organization (PHO)FWA TRAINING MATERIALS ATTESTATION FORMI, ___ (Provider) have received, reviewed and understand the FWA Training and Code of Conduct

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How to fill out fraud waste and abuse

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Understand the definition of fraud, waste, and abuse.

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Review the guidelines and policies related to fraud waste and abuse in your organization.

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What is fraud waste and abuse?

Fraud waste and abuse refer to practices that result in unnecessary costs or improper payments in health care, insurance, and other programs. Fraud involves intentional deceit for gain, waste is the overutilization of services or payments for unnecessary services, and abuse includes practices that are inconsistent with accepted sound medical, business, or fiscal practices.

Who is required to file fraud waste and abuse?

Individuals and organizations that provide services or submit claims to government programs or insurers, such as healthcare providers, contractors, and certain employees, are required to file reports regarding fraud waste and abuse.

How to fill out fraud waste and abuse?

To fill out a fraud waste and abuse report, gather relevant documentation, detail the suspected incident, include specific facts and figures, and submit it to the appropriate authorities, often through designated reporting forms or systems.

What is the purpose of fraud waste and abuse?

The purpose of fraud waste and abuse prevention is to protect public funding, ensure resources are used effectively, maintain program integrity, and provide quality care and services.

What information must be reported on fraud waste and abuse?

When reporting fraud waste and abuse, individuals should include names of involved parties, details of the incident, nature of the waste or fraud, date and times, and any documentation or evidence supporting the report.

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