How to detect healthcare fraud? "A systematic review".

OBJECTIVE: To identify the method used in detecting fraud cases. METHODS: Articles searching by using topic-appropriate keywords and incorporated into search engines (data-based) journals Pubmed/Medline, Cochrane, Wiley, ScienceDirect, and secondary data-based Google scholar. Then data extraction is done based on inclusion criteria. The selected articles have the aim of investigating/detecting cases of fraud that have occurred in the health sector or other related sectors that support the study. RESULTS: The findings of the nine reviewed articles have suggested that most of the fraud perpetrators are performed by medical personnel (doctors) and providers. Many types of fraud occur such as insurance claims or medical actions that are completely unadministered nor following the procedure and duplicating claims. The methods that appropriate to be used in detecting fraud are secondary data tracking, information, and technology specialist provision. CONCLUSION: Secondary data tracking is the most widely used method in fraud detection. Fraud perpetrators are ones who dominated by medical circles with fictitious claim cases. Perpetrators tend not to act themselves but in organizations with network.

Combination model in reducing HIV-related stigma: A systematic review

Objective: This article identifies and explains the various research models related to HIV stigma. Methods: This systematic review is done using the PRISMA 2015 guidelines. Source of this review uses 3 online journal databases which are Pubmed, Scinapse, Elsevier. Search criteria include articles published this past 10 years between 2010 and 2020. Result: 4146 articles were obtained and 9 articles which are suited with the inclusion criteria and were chosen in the literature review. It was discovered that stigmatization is a cultural construct and its experiences varies between countries and communities. Models which differentiate are interpersonal and intrapersonal process in handling the stigma. Conclusion: Stigmas are still an important issues because often times it became an obstacle in the effort to reduce the prevalence of HIV/AIDS. Therefore there needs to be a gold standard scenario in reducing HIV related stigma, one of them being cultural in source. (AU)

How to detect healthcare fraud? “A systematic review”

Objective: To identify the method used in detecting fraud cases. Methods: Articles searching by using topic-appropriate keywords and incorporated into search engines (data-based) journals Pubmed/Medline, Cochrane, Wiley, ScienceDirect, and secondary data-based Google scholar. Then data extraction is done based on inclusion criteria. The selected articles have the aim of investigating/detecting cases of fraud that have occurred in the health sector or other related sectors that support the study. Results: The findings of the nine reviewed articles have suggested that most of the fraud perpetrators are performed by medical personnel (doctors) and providers. Many types of fraud occur such as insurance claims or medical actions that are completely unadministered nor following the procedure and duplicating claims. The methods that appropriate to be used in detecting fraud are secondary data tracking, information, and technology specialist provision. Conclusion: Secondary data tracking is the most widely used method in fraud detection. Fraud perpetrators are ones who dominated by medical circles with fictitious claim cases. Perpetrators tend not to act themselves but in organizations with network. (AU)