A billing and coding specialist discovers a suspicious billing activity that may be fraudulent in the workplace. What action should the specialist take?

When faced with suspicious billing activity that may indicate fraud, the most appropriate course of action is to call the U.S. Department of Health and Human Services (DHHS) anonymous hotline. This hotline allows individuals to report suspected fraud in a secure and confidential manner and ensures that the concerns are directed to the proper authorities who can investigate the matter thoroughly.

Utilizing the DHHS hotline not only adheres to legal and ethical standards but also protects the integrity of the healthcare system. Reporting to this official source can help initiate an investigation, leading to corrective measures if fraud is substantiated.

Although notifying the provider or reporting to the billing manager might seem like direct actions to take, these routes could compromise the investigation or allow the fraudulent behavior to continue unchecked. Ignoring the activity is never appropriate, as it could allow fraudulent practices to persist, potentially leading to greater financial losses and legal repercussions. Thus, contacting the DHHS hotline is the most responsible and effective method to address potential fraud in a billing and coding context.