Which of the following is an example of an unethical practice that could be reported to Compliance?

• A. Ethical billing practices
• B. Complete compliance
• C. Unethical billing practices
• D. None

Answer: (C)

Spotting unethical billing practices that must be reported to Compliance is the focus here. Unethical billing practices violate laws and organizational policies and constitute potential fraud, waste, or abuse. That status makes this the best choice because it pinpoints conduct that should be escalated to Compliance for investigation and remediation. To put it in context, ethical billing practices reflect accuracy and honesty in billing, while “complete compliance” refers to overall adherence to rules rather than identifying a specific wrong, and “none” would suggest there’s nothing to report. Examples that illustrate the concept include billing for services not performed, upcoding (charging for a higher-level service than was provided), duplicate billing, or phantom charges. When you encounter these, report them promptly to Compliance to help protect patients, the organization, and adherence to applicable laws and regulations.