Which term describes billing separately for services that should be bundled?

Which term describes billing separately for services that should be bundled?

• A. Upcoding
• B. Fee Splitting
• C. Unbundling
• D. Stark Law

Answer: (C)

Billing separately for components that should be billed as a single unit is called unbundling. This happens when related services that are typically paid together are itemized as separate procedures to inflate reimbursement. It’s considered improper billing and can be viewed as fraud or abuse because the payer is charged more than the bundled service would justify. By comparison, upcoding means charging for a more expensive service than was provided; fee splitting involves sharing fees with another party inappropriately; and the Stark Law concerns physician self-referral restrictions rather than the act of separating bundled services.

Billing separately for components that should be billed as a single unit is called unbundling. This happens when related services that are typically paid together are itemized as separate procedures to inflate reimbursement. It’s considered improper billing and can be viewed as fraud or abuse because the payer is charged more than the bundled service would justify. By comparison, upcoding means charging for a more expensive service than was provided; fee splitting involves sharing fees with another party inappropriately; and the Stark Law concerns physician self-referral restrictions rather than the act of separating bundled services.