Question

An upcode occurs when the provision of care to a patient results in unusually high costs to the home care agency

a. True
b. False

Answer 1

The statement about upcoding is false; upcoding is a fraudulent practice of billing for more expensive services than provided.

Step-by-step explanation:

The statement that an up code occurs when the provision of care to a patient results in unusually high costs to the home care agency is false. Upcoding is actually a fraudulent practice where healthcare providers submit codes to insurance companies for more serious (and expensive) diagnoses or treatments than the patient actually needs or receives. This unethically leads to the provider receiving a higher payment than is justified. It is important for medical billing to be accurate and reflect the true service provided to avoid legal consequences and maintain the integrity of the healthcare system.