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AHIP Exam AHM-530 Topic 6 Question 90 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 90
Topic #: 6
[All AHM-530 Questions]

The Ross Health Plan compensates Dr. Cecile Sanderson on a FFS basis. In order to increase the level of reimbursement that she would receive from Ross, Dr. Sanderson submitted the code for a comprehensive office visit. The services she actually provided represented an intermediate level of service. Dr. Sanderson's action is an example of a type of false billing procedure known as

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Suggested Answer: A

Contribute your Thoughts:

Clement
1 days ago
Wow, talk about a bold move. Upcoding, really? That's like trying to sneak a moose through airport security. Not exactly subtle, is it?
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Jesusa
8 days ago
Hmm, let's see here... Upcoding, gotcha. I bet she thought she could slip that one past the auditors. No such luck!
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Haley
13 days ago
Aha! Upcoding, that's the one. Dr. Sanderson's tryin' to game the system for a few extra bucks. Not cool, doc, not cool.
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Arminda
18 days ago
I'm not sure, but I think upcoding is when you bill for a higher level of service than what was actually provided.
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Lisha
19 days ago
I agree with Trinidad, Dr. Sanderson's action seems like upcoding to me.
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Trinidad
22 days ago
I think the answer is D) Upcoding.
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