Câu 36: CFE - Financial Transactions and Fraud Schemes: Certified Fraud Examiner - Financial Transactions and Fraud Schemes

Which of the following scenarios is an example of upcoding?

1. A. Dr. Johnson, a psychiatrist, regularly sees patients for sessions lasting less then forty minutes, but she submits the claims with a code that indicates the sessions were sixty minutes long. — đáp án hiện tại
2. B. Victor receives payment in exchange for undergoing an unnecessary medical procedure that is then billed to his health care program.
3. C. Margot inflates a medical bill she is seeking reimbursement for by adding an additional digit to the amount charged.
4. D. Dr. Hernandez uses four procedure codes when submitting a claim for a coronary bypass he performed that is supposed to be billed using a single procedure code.