AHIP Exam AHM-530 Topic 6 Question 90 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 90
Topic #: 6

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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Haley

4 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

9 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

10 days ago

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

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Trinidad

13 days ago

I think the answer is D) Upcoding.

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