Understanding Unbundling Medical Billing and Its Implications

unbundling medical billing

Most people trust their medical bills and believe they are 100% accurate. Although most medical bills feature correct rates and fees, sometimes coding issues occur, causing patients to overpay. This is known as unbundling medical billing.

To teach you more about unbundling medical billing, our team at PracticeForces developed a guide explaining the practice and how it can cause patients to overpay for medical treatments.

PracticeForces is one of Florida’s leading medical billing management services. We help healthcare providers manage and improve their medical billing practices to increase revenue without sacrificing patient care. Whether you want to learn more about HIPAA in medical billing or understand unbundling medical billing, our experts are here to help.

What Is Unbundling Medical Billing?

Unbundling medical billing is when an unintentional or intentional coding issue occurs and increases a patient’s medical bills, causing them to pay more than necessary. Medical services utilize codes created by the American Medical Association called Current Procedural Terminology (CPT) codes. CPT codes help insurance companies standardize medical procedures and service descriptions that medical providers use to receive payment.

Medical providers hire coders to convert medical documents to CPT codes before sending patients their bills. Unbundling medical billing happens when a coder separates two medical services instead of bundling them together, overcharging the insurer and the patient.

For example, if you have two medical procedures done simultaneously, coders bundle the costs in one CPT code. If the coder doesn’t bundle the procedure costs, unbundling medical billing occurs and overcharges the patient and insurance company.

Why Unbundling Medical Billing Happens

Understanding what causes unbundling is essential for every medical practice. Here are the top ones:

Lack of Understanding

Most unbundling medical billing occurs when the coder doesn’t understand the Current Procedural Terminology system. They often misread the code and make mistakes due to a lack of experience or knowledge of the program.


Sometimes coders assume a medical practitioner provided two services separately when they performed them simultaneously. Coders must bundle the two services when this happens. If they don’t bundle the services together, unbundling occurs.


Unsavory coders and medical offices sometimes overcharge patients purposely using unbundling medical billing. They intentionally unbundle the services to increase their profits. Although rare, deliberate unbundling medical billing isn’t unheard of and can adversely affect unsuspecting patients.


Errors can also create unbundling medical billing and overcharge patients for medical services unintentionally. One or two mistakes can result in denied or delayed payments. However, numerous errors can cause the federal government to conduct a fraud investigation.

Contact PracticeForces for Professional Medical Billing Management Services in Florida

If you want to prevent unbundling medical billing in your clinic, contact us at PracticeForces. Our team can assess your office’s medical bills to ensure your patients receive accurate statements. We’ve helped medical practitioners manage their billing for 18 years, giving us the experience to handle all your medical billing needs.

From managing medical records to understanding claim denials, PracticeForces is here for you.

Call us at (727) 499-0351 or visit our website’s Contact Us page and see what our team can do for you today!

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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