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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

ACost shifting

BChurning

CUnbundling

DUpcoding

Show Suggested Answer

Suggested Answer: A

by Leonor at Jun 23, 2024, 05:05 AM

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Edwin

1 months ago

Upcoding, the classic 'Robin Hood' approach to healthcare billing. Steal from the insurance, give to the... well, yourself, I suppose.

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Man

C: Dr. Sanderson's actions could lead to legal consequences.

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Jolene

2 days ago

B: It's unethical to bill for services not actually provided.

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Kris

8 days ago

A: Upcoding is a serious issue in healthcare.

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Olen

2 months ago

Upcoding, huh? Guess Dr. Sanderson's been watching too many episodes of 'Breaking Bad: Medical Edition'.

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Lanie

10 days ago

D) Upcoding

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Fredric

17 days ago

C) Unbundling

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Hershel

20 days ago

B) Churning

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Sharee

1 months ago

A) Cost shifting

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Clement

2 months 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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Earleen

1 months ago

She should have just provided the services she billed for.

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Shawnee

1 months ago

It's definitely not a subtle way to increase revenue.

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Yolande

1 months ago

Dr. Sanderson must have been desperate for more reimbursement.

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Viola

2 months ago

I know right, upcoding is a risky move.

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Jesusa

2 months 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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Peggie

1 months ago

User 2: Yeah, trying to get more money by billing for a higher level of service than actually provided.

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Pauline

1 months ago

User 1: Upcoding, that's a sneaky move.

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Haley

2 months 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

2 months 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

2 months ago

I agree with Trinidad, Dr. Sanderson's action seems like upcoding to me.

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Trinidad

3 months ago

I think the answer is D) Upcoding.

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