Which of the following actions is an example of healthcare fraud?

Prepare for the RHIT Domain 5 Test with our engaging quiz. Test your knowledge with multiple choice questions, clarify doubts with hints and explanations, and boost your readiness for the exam!

Billing for services not furnished to patients is a clear example of healthcare fraud because it involves intentionally deceiving a payer for financial gain. This type of fraudulent activity creates a false record of care that was never provided, which both violates ethical standards and legal regulations. It undermines the trust in the healthcare system and can lead to significant financial and legal repercussions for the provider engaged in such deceitful practices.

In contrast, billing for services actually rendered is a standard and lawful practice, ensuring that providers receive payment for the actual care they deliver. Refiling claims after they are denied is a typical administrative action taken by providers to ensure they are fairly compensated for services rendered; this does not constitute fraud if done in compliance with regulations. Using a claim scrubber before submission is a quality control measure aimed at reducing errors in billing and does not pertain to fraudulent activity. Thus, these actions differ significantly from the fraudulent behavior represented by billing for services that were never provided.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy