Certified Fraud Examiner Practice 2025 - Free Practice Questions and Study Guide

Underbilling is not typically classified as healthcare fraud. Healthcare fraud generally involves intentional deception or misrepresentation to gain an undeserved advantage, which means it usually encompasses actions where healthcare providers seek to overcharge or mislead insurers, rather than underreport services. Underbilling, in contrast, occurs when a provider fails to bill for the full amount owed for services rendered, which is usually considered a mistake rather than a fraudulent act.

Falsified prescriptions involve knowingly writing prescriptions for medication that is not needed or not for legitimate purposes. This constitutes fraud as it involves deception for financial gain. Excessive supplies refers to providers billing for more medical supplies than are actually required for patient care. This is fraudulent behavior because it inflates costs and misrepresents the actual care provided. Scooter scams involve the provision of unnecessary scooters or wheelchairs to patients, often facilitated by deceptive practices to obtain payment from Medicare or insurance, which is again a clear case of fraud. Thus, underbilling stands apart from these other acts as it does not inherently involve deceit or an attempt to illicitly gain funds.