Module Eight Journal Guidelines and Rubric
Overview
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In this course, journals are used for reflection. Journal activities in this course are private between you and the instructor. For this journal task, you will review the module resources on fraud detection.
Prompt
First, review “Medicare Fraud and Abuse: Prevention, Detection and Reporting” and “Using Data Mining to Detect Health Care Fraud and Abuse: A Review of Literature,” located in the Required Resources section of the module. Next, prepare a brief memo to management suggesting a fraud surveillance model and draft a policy statement to ensure the model is implemented.
Address the following critical elements in the journal assignment:
- Prepare a brief memo to management suggesting a fraud surveillance model.
- Draft a policy statement to ensure the fraud surveillance model is implemented. Be sure to include a timeline outlining how often the fraud surveillance should take place.
- Explain why the tools used by fraud surveillance models to detect trends in data are effective.
- How will your healthcare organization use this information to prevent and detect fraud and abuse?
Support your responses by referencing the module resources and other course resources.
What to Submit
Submit the assignment as a Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Your journal assignment should be 4 to 6 paragraphs in length.
Module Eight Journal Rubric
| Criteria | Proficient (100%) | Needs Improvement (70%) | Not Evident (0%) | Value |
|---|---|---|---|---|
| Does not prepare a brief memo to management suggesting a fraud surveillance model | 22 | |||
| Does not draft a policy statement to ensure the fraud surveillance model is implemented | 22 | |||
| Does not explain why the tools used by fraud surveillance models to detect trends in data are effective | 22 | |||
| Does not explain how the healthcare organization will use the information to prevent and detect fraud and abuse | 22 | |||
| Journal assignment contains errors of organization and grammar making the assignment difficult to understand | 12 | |||
| 100% |
