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ATI-Health Care Fraud and Waste Abuse Questions and Answers | Latest Version | 2025/2026 | Correct & Verified
What is an example of health care fraud in a clinical setting?✔✔Billing for services that were never provided to the patient.
How can a nurse help prevent waste in the healthcare system?✔✔By accurately documenting care, avoiding unnecessary tests, and using supplies responsibly.
What is a red flag that could indicate potential abuse in a billing practice?✔✔Consistent upcoding of procedures to higher-paying codes without justification.
Why is it important for healthcare workers to report suspicious activity?✔✔Because early reporting can prevent further abuse and protect patients and healthcare resources.
What should a nurse do if they suspect a colleague is falsifying patient records?✔✔Report the concern to a supervisor or compliance officer according to facility policy. 1 / 2
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What is the main difference between waste and fraud in healthcare?✔✔Fraud is intentional deception for gain, while waste is the careless misuse of resources without intent to deceive.
What can happen if healthcare fraud is not addressed?✔✔It can lead to loss of funding, legal penalties, and reduced access to care for patients.
How can an employee help detect fraud in billing processes?✔✔By double-checking documentation and matching services with billing codes before submission.
Why is accurate timekeeping important in home health care services?✔✔Because overreporting hours can result in fraudulent billing and financial penalties.
What is one simple way to prevent duplicate billing?✔✔Ensure that documentation is complete and submitted only once through proper channels.
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