List and define three of the risky behaviors coders should ...

[lunatika]

List and define three of the risky behaviors coders should avoid.

Question 2

Federal legislation that prohibits submission of claims for services not rendered or for any services considered fraudulent upon investigation is called the ___________________ _.
 
 Indicate whether the statement is true or false

[bobsmith]

Answer to Question 1

Unbundling - submitting multiple codes in a variety of ways to get more reimbursement
Downcoding - using a lower code to be safe from denial.
Upcoding - choosing a higher paying code that is not supported by the documentation.
Frequency - attempting to report a service in an unusual manner to be able to bill more often than is allowed.
Partial professional courtesy - accepting only the portion the insurance will pay from a patient (when that is not the agreement with the insurance company)

Answer to Question 2

False Claims Act

[lunatika]

TYSM

[aliotak]

Excellent