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ACFE Certified Fraud Examiner - Financial Transactions and Fraud Schemes
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Question #15
#15
Multiple Choice
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Which of the following scenarios is an example of upcoding?
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.
B.
Victor receives payment in exchange for undergoing an unnecessary medical procedure that is then billed to his health care program.
C.
Margot inflates a medical bill she is seeking reimbursement for by adding an additional digit to the amount charged.
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.
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Question 15 of 254
Exam CFE---FINANCIAL-TRANSACTIONS-AND-FRAUD-SCHEMES Topic 1 Question 15
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