unbundling


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The practice of expanding into individual units a group of diagnostic or procedural test codes—based on the 4th edition of Current Procedural Terminology (CPT) coding promulgated by the American Medical Association—that might have been previously included as a ‘panel’, to maximise reimbursement from third party payers

unbundling

Exploding Medicare reimbursement A fraudulent practice in which provider services–eg, blood or chemistry panels are broken down to their individual components, resulting in a higher payment by Medicare. See Fraud, HIPA Act, Rebundling, Upcoding.

un·bund·ling

(ŭn-bŭnd'ling)
Use of several Current Procedural Terminology codes for a service when one inclusive code is available.

unbundling

Separately billing for laboratory tests or procedures that are normally linked in order to extract more money from a payer (such as Medicare). This practice is illegal in the U.S.
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References in periodicals archive ?
Decoupling or unbundling services from the delivery of hearing aids is a complex process requiring a careful analysis of a practice's costs as well as the demands of the marketplace.
He added that the unbundling and simultaneous listing of Nictus Namibia on the NSX will enhance the strategic flexibility of the Namibian operations and South African operations and will enable the two separately listed entities to embark on their own strategy to grow within their respective commercial and regulatory environments.
First, the University of Washington's Paul Hill and Colorado State Senator Mike Johnston sketch a framework for thinking about unbundling and consider what new, unbundled schooling models might look like in practice.
As explained by the government, this essentially foresees full ownership unbundling in both the electricity and gas sectors.
Advocates of total unbundling say the proposal would leave the parent utility in control of financial decisions, giving it leverage over decisions taken by the transmission company.
The defining element of an ownership unbundling model is that the network of electricity transmission is operated and owned by one independent company, which clarifies the incentives, responsibilities and liabilities for the network, but unbundling does not necessarily mean lower tariffs," stated Dr Dirk Buchta, managing director of A T Kearney Middle East.
Substantial" change as to initial texts was necessary, according to Loos, due to the excessive concentration on ownership unbundling and independent system operators.
The trend is driven by consumer demand," said Forrest Mosten, a Los Angeles lawyer who was the keynote speaker at the 2000 conference (and a similar one in 2006) and is author of Unbundling Legal Services: Haw to Deliver Legal Services a la Carte for Improved Service and Profits.
Alternative operators are turning more and more to unbundling for supplying internet services, and turning away from the incumbent's wholesale offers (bitstream and simple resale).
And, like Scrooge, we have it in our power to shape our own future, white recognizing there are certain aspects of the unbundling of the campus that cannot be reversed.
Unbundling has been described as ordering "a la carte," rather than from the "full-service menu.
The ABA has also identified unbundling as the number one way to increase access to the courts, she said.