AHIP AHM-530 Exam - Topic 2 Question 21 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 21
Topic #: 2

Dr. Leona Koenig removed the appendix of a plan member of the Helium health plan. In order to increase the level of reimbursement that she would receive from Helium, Dr. Koenig submitted to the health plan separate charges for the preoperative physical examination, the surgical procedure, and postoperative care. All of these charges should have been included in the code for the surgical procedure itself. Dr. Koenig's submission is a misuse of the coding system used by health plans and is an example of:

AUpcoding

BA wrap-around

CChurning

DUnbundling

Show Suggested Answer

Suggested Answer: D

by Kattie at May 10, 2022, 01:59 AM

Limited Time Offer

25%

Off

Get Premium AHM-530 Questions as Interactive Web-Based Practice Test or PDF

Contribute your Thoughts:

Submit Cancel

Lina

5 months ago

Nope, this is classic unbundling, no doubt about it.

upvoted 0 times

...

Nana

5 months ago

I thought upcoding was the bigger issue here?

upvoted 0 times

...

Anglea

5 months ago

Wait, can you really get in trouble for that?

upvoted 0 times

...

Filiberto

5 months ago

Totally agree, she's trying to game the system.

upvoted 0 times

...

Selma

5 months ago

That's definitely unbundling.

upvoted 0 times

...

Lashanda

6 months ago

I'm a bit confused by this question. I'll need to review my notes on the Control process blade to make sure I have a solid understanding of its responsibilities.

upvoted 0 times

...

Fallon

6 months ago

Hmm, I'm a little confused by the wording on some of these options. I'll need to review the live migration process again to make sure I understand which steps are actually required here.

upvoted 0 times

...

Stevie

6 months ago

The question is asking for two characteristics, so I'll need to make sure I select the two most relevant options. Let me think this through step-by-step.

upvoted 0 times

...