One Example of Health Care Fraud Involves Billing for More

question 93

Multiple Choice

One example of health care fraud involves billing for more expensive services or procedures than were actually provided or performed. This practice is termed ______ and requires "inflation" of the patient's diagnosis code to a more serious condition consistent with the false procedure code.

• A) ladder coding
• B) trade coding
• C) upcoding
• D) step coding

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Definitions:

Net Asset Value

Net Asset Value (NAV) is the total value of a fund's assets minus its liabilities, often used to price shares of mutual funds and ETFs.

Net Asset Valuation

A method of valuing a company or an investment fund, calculated by subtracting total liabilities from total assets.

Net Income Determination

The process of calculating a company's total earnings after subtracting all expenses, including taxes and costs, from total revenues.

Accrual Accounting

An accounting method that records revenues and expenses when they are incurred, regardless of when cash transactions occur.