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Rebecca S. Busch RN, MBA, CCM, CBM, CPC, CHS-III, CFE, FIALCP, FHFMA
A pioneer in conducting technology and process enabled audits of healthcare claims and processing, Rebecca has developed patent-pending proprietary data analysis tools, including a data anomaly system that profiles and tracks medical and financial errors. Her proprietary methodology employs statistical analysis of claims and procedural data – specifically targeted to identify the most probable areas of operational breakdowns, medical and financial errors, exposure to fraud, waste and abuse, and cost savings. Rebecca’s ability to quickly identify anomalies from vast amounts of data has distinguished her and Medical Business Associates as an invaluable source of valuable cost-savings for clients. Rebecca entered the healthcare industry as a nurse and became a hospital medical auditor setting up internal controls for documentation and reimbursement issues. She also set up audit programs for insurance carriers. Throughout her career she has been an advocate for individual patients who have found themselves “stuck” in the system. This eventually led to the creation of a Personal Health Record built on a case management framework that prevents both financial and medical errors. Today, Rebecca executes her vision by conducting audits of employers, hospitals, insurance companies, patients and other ancillary market participants to help them manage their healthcare costs. She also trains clinical professionals on audit and finance. In addition, she investigates fraud and testifies as an expert witness in disputes in the areas of healthcare reimbursement, internal controls, life care expense analysis, patient care documentation and respective damages. An accomplished educator, Rebecca has published more than 100 articles and presentations (see Presentations and Publications) and authored three books: Health Care Fraud and Detection Guide -- a comprehensive guide for auditing and detecting healthcare fraud, and Healthcare Portfolio – a “how-to” book that teaches American families how to detect fraud in reviewing their own medical bills. She has contributed the case study “I Do” regarding identity theft to Case Studies in Computer Fraud by Joseph T. Wells (editor) and Chapter 59 “Bodies for Rent” for Fraud Casebook: Lessons from the Bad Side of Business by Joseph T. Wells (editor). Her most recent book is Electronic Health Records: An Audit & Internal Control Guide. Rebecca is also a faculty member of the Association of Certified Fraud Examiners. Her appointments include:
Other Board Member Activity include:
For more information on Rebecca Busch or for a complete resume, please fill out a request form. |
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Rebecca formed Medical Business Associates, Inc. with the vision of
delivering a multi-disciplined approach to conducting comprehensive
audits for employers, hospitals, and insurance companies.