Healthcare Fraud: Auditing and Detection Guide, 2nd Edition

What Is Data Mapping?

Data mapping involves the identification of all possible data elements for study. In order to not miss any critical elements, it is important to understand the movement and content of data elements. Movement of the data may help identify modifications of the data element that should be collected. In addition, understanding the content and meaning of the data element helps to ensure that any modification or transition status of a data element is collected as well. In this book, the data elements are derived from any component or series of components of the primary healthcare continuum (P-HCC), secondary healthcare continuum (S-HCC), information healthcare continuum (I-HCC), consequence healthcare continuum (C-HCC), transparency healthcare continuum (T-HCC), and rules based healthcare continuum (R-HCC). The audit and investigative six-layered continuum model may be collectively referred to as the healthcare continuum components model (HCC Model). Further, these components are mapped out for the respective pipelines previously discussed: health information pipelines (HIPs), accounts receivable pipelines (ARPs), operational flow activity (OFA), service market activity (SMA), product market activity (PMA), and consumer market activity (CMA). The delineation and representation of the data involve a series of steps. Keep in mind that mapping protected health information (PHI) and creating a road map will help in discerning hidden data patterns that will make anomalies ...