Unbundling is a deceptive medical billing practice that steals from government healthcare programs and the public. If you suspect fraud against the government, you can help stop it – and even receive a reward for your efforts.
Medicare and Medicaid often require certain healthcare services or procedures to be billed as a single “bundle” under a comprehensive code. This system is designed to reduce costs and prevent unnecessary services.
What happens when a provider breaks the bundle apart and assigns individual codes to different components? The provider benefits (illegally) because Medicare and Medicaid end up paying them more. This is called unbundling fraud, and it cheats the public by redirecting life-saving government healthcare resources from the people who need them.
Have you noticed a pattern of this type of unbundling billing? If so, you may have valuable information about Medicare or Medicaid unbundling fraud, and you may be able to expose this unethical billing behavior by filing a claim under the False Claims Act.
You may even be eligible to receive up to 30% of any recovery for your assistance.
Do you suspect unbundling fraud? At Carolina Whistleblower Attorneys, we’re experienced in pursuing whistleblower claims in North and South Carolina for Medicaid and Medicare healthcare billing fraud. Contact us today at 1-888-292-8852 for a free, confidential discussion that can give you peace of mind and help you decide how you want to proceed.
Unbundling occurs when healthcare providers separate components of a single procedure or service and bill them individually to maximize reimbursement, even though Medicare and Medicaid require that they should be billed as one bundled service.
Fraudulent medical providers employ unbundling schemes by:
For example, Medicare or Medicaid may require that a single surgery (which includes preoperative care, the surgical procedure, and post operative follow-up) be billed under one code. But an unscrupulous provider may instead bill separately for the preoperative care, the surgery, and the post operative visits – and inflate the total cost.
Why is unbundling considered fraudulent?Unbundling violates Medicare and Medicaid rules because it artificially inflates the cost of services and misrepresents the actual care provided. This practice wastes taxpayer dollars and undermines efforts to keep healthcare costs under control. By diverting resources from legitimate needs, Medicaid and Medicare unbundling fraud weakens the overall integrity of these government healthcare programs.
If you suspect or have witnessed Medicare or Medicaid unbundling fraud, call us for a 100% free and confidential consultation at 1-888-292-8852.
In addition to medical provider staff noticing billing deviations from standard procedures, the following auditing processes can help detect unbundling and other types of Medicare and Medicaid healthcare billing fraud:
An experienced whistleblower attorney can help you report Medicare and Medicaid unbundling fraud by filing a qui tam lawsuit on behalf of the government under the False Claims Act. This may involve:
If you suspect Medicare or Medicaid fraud and are considering taking steps towards exposing it, it’s important to know your rights. And we can help. Our whistleblower team is led by former U.S. Attorney Bill Nettles. Under his leadership and during his tenure, South Carolina became one of the top four states in the nation for whistleblower recoveries.1,4
Our mission is to expose fraud against the government, and we stand with those who have the courage to report all types of medical billing fraud involving Medicare and Medicaid. Our client success stories prove our dedication to seeking justice.1,4
We operate on a contingency fee basis, which means we cover all the costs of building your case, and you don’t pay a penny unless we win an award for you—guaranteed.2 With our You-First Policy, your interests come first every step of the way.
Whistleblowers play a critical role in identifying unbundling schemes. If you suspect Medicare or Medicaid healthcare billing fraud, let’s have a confidential conversation. We can answer your questions and help you explore your options. The consultation is free, and there’s no obligation.
Contact us online or call 1-888-292-8852 today!
If you’re wondering if it’s a good idea to speak with a whistleblower lawyer about what you know, let us set the record straight.
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