Question

Codes are associated with reimbursement rates and therefore, there are inherent incentives to code so the healthcare facilities will receive the lowest reimbursement dollar amount possible.

a. True
b. False

Answer 1

The claim that healthcare coding incentives are structured to receive the lowest reimbursement amount is false.

Step-by-step explanation:

The statement that codes are associated with incentives for healthcare facilities to receive the lowest reimbursement dollar amount possible is false. In a fee-for-service system, providers are reimbursed based on the cost of the services provided and may be incentivized to provide more services, as this would typically lead to higher reimbursements. Conversely, health maintenance organizations (HMOs) give a fixed reimbursement per patient, which may encourage providers to manage the quantity of care judiciously to prevent higher costs later.

Healthcare providers are reimbursed more for providing additional services in fee-for-service systems, while HMOs offer fixed reimbursements per patient.