question archive Explain the steps HIM professionals should take to report suspected fraud and abuse in collecting data such as the one described in the following scenario
Explain the steps HIM professionals should take to report suspected fraud and abuse in collecting data such as the one described in the following scenario
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Explain the steps HIM professionals should take to report suspected fraud and abuse in collecting data such as the one described in the following scenario.
While reviewing a rejected claim as a clinical documentation analyst, you noticed that a hysterectomy on a patient was recorded in the medication reconciliation section of the EHR as hysteroscopy. After comparing the two, you noticed that hysteroscopy costs way less than the actual procedure done on the patient. Upon further digging, you discovered that the error had happened repeatedly during the same year. You also found that hysterectomy is just one step up from hysteroscopy on the drop-down box in the medication reconciliation section in the EHR.
P.S. Answer doesn't have to be based on the scenario
