Question

Which of the following is an example of fraud?

A. Leaving a field blank on the claim
B. Accidentally coding a diagnosis incorrectly
C. Appealing a denied service
D. Altering patient documentation to increase levels of reimbursement

Answer 1

Altering patient documentation to increase levels of reimbursement is an example of fraud in healthcare.

Step-by-step explanation:

Altering patient documentation to increase levels of reimbursement is an example of fraud in healthcare. Fraud refers to intentional misrepresentation or deceit for personal gain. In this case, altering patient documentation with the intention of increasing reimbursement levels is a fraudulent activity that can result in financial loss for healthcare providers and insurers.

Leaving a field blank on a claim, accidentally coding a diagnosis incorrectly, and appealing a denied service are not examples of fraud but rather potential errors or legitimate actions within the healthcare industry. Leaving a field blank on a claim may lead to denial or delay in reimbursement, but it is not fraudulent if unintentional. Coding errors can occur due to human error, and appealing a denied service is a common practice to seek reimbursement for services provided.