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A recent audit discovered a recruited billing specialist is not following the standard billing guidelines. It appears they made numerous billing errors on patients charts
A recent audit discovered a recruited billing specialist is not following the standard billing guidelines. It appears they made numerous billing errors on patients charts and noncompliant with the hospital's standard process. After investigation, it determines that it is fraudulent billing.
1. What are the legal and compliance implications of the billing specialist's actions.
2. How should the manager and hospital should respond to this issue and what measures should be taken to prevent recurrence?
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