The Ross Health Plan compensates Dr. Cecile Sanderson on a FFS basis. In order to increase the level of reimbursement that she would receive from Ross, Dr. Sanderson submitted the code for a comprehensive office visit. The services she actually provided represented an intermediate level of service. Dr. Sanderson's action is an example of a type of false billing procedure known as

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Dr. Sanderson's action is an example of upcoding, which involves submitting codes for more complex or expensive services than were actually performed in order to increase reimbursement.

The Ross Health Plan Compensates Dr