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Questions and Answers
What is the term for submitting separate claims to insurance provider for services that could fit on a single bill?
What is the term for falsely assigning a higher billing code to a service?
What is the term for deliberately assigning a lower billing code to a service to reduce reimbursement?
What is the term for intentionally breaking a procedure or service into its component parts to maximize reimbursement?
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What term describes the fraudulent act of altering medical records to support incorrect billing?
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What is the term for submitting separate claims to insurance provider for services that could fit on a single bill?
Signup and view all the answers
What is the term for deliberately assigning a lower billing code to a service to reduce reimbursement?
Signup and view all the answers
What is the term for falsely assigning a higher billing code to a service?
Signup and view all the answers
What term describes the fraudulent act of altering medical records to support incorrect billing?
Signup and view all the answers
What is the term for intentionally breaking a procedure or service into its component parts to maximize reimbursement?
Signup and view all the answers
Study Notes
Insurance Fraudulent Practices
- Unbundling: submitting separate claims to insurance provider for services that could fit on a single bill.
- Upcoding: falsely assigning a higher billing code to a service.
- Downcoding: deliberately assigning a lower billing code to a service to reduce reimbursement.
- Fragmentation: intentionally breaking a procedure or service into its component parts to maximize reimbursement.
- Falsification of records: fraudulent act of altering medical records to support incorrect billing.
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Description
Test your knowledge of compliance and regulatory practices in medical coding with this set of practice questions. Learn about submitting separate claims to insurance providers for services and more. Join Dr. Coda's medical coding class to master these important concepts!
