What can result from upcoding in medical billing?

Upcoding in medical billing refers to the practice of billing for a more expensive service or treatment than what was actually provided. This practice can lead to serious fines and penalties for healthcare providers and organizations.

When an entity engages in upcoding, they violate regulations and guidelines set forth by federal and state laws, including the False Claims Act. This can result in investigations by regulatory bodies, audits, and ultimately financial penalties if the practice is discovered. In severe cases, it could also lead to legal action and loss of credibility in the healthcare field.

The other options do not align with the consequences of upcoding. Upcoding does not facilitate increased accessibility to healthcare services or enhance patient satisfaction. In fact, it can undermine trust in the healthcare system. Additionally, legitimate claims might be processed quickly, but upcoding leads to complications that could prolong claim processing or even result in claim denials. Thus, serious fines and penalties are a direct and significant outcome of upcoding practices.