Certified in Healthcare Compliance (CHC) Practice Test 2025 – Complete Exam Prep

Question: 1 / 400

What best defines the concept of 'unbundling' in healthcare billing?

Separating claims that should be billed as one

The concept of 'unbundling' in healthcare billing refers to the practice of separating claims that should be billed as one comprehensive service into multiple individual claims. This can lead to higher reimbursements by billing separately for each component of a service rather than as a single bundled service. Unbundling violates billing regulations because it misrepresents the nature of the services provided and can result in overbilling for the services rendered.

In the context of medical billing compliance, it is essential to ensure that services are billed accurately in accordance with the established coding guidelines and that bundled services are appropriately billed as such. This helps to maintain transparency, integrity, and compliance within the billing process, ensuring that the healthcare providers are compensated fairly for the services rendered while adhering to legal standards.

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Inflating billing amounts for services rendered

Providing kickbacks for referring patients

Underbilling for services

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