Which term means the return of a part of the sum received for services because of a prior agreement or coercion?

• A. Kickback
• B. Fraud
• C. Upcoding
• D. Unbundling

Answer: (A)

Kickback describes the return of part of the money received for services because of an existing agreement or coercion. In healthcare and other settings, it’s a paid incentive to influence referrals or service choices—someone profits by steering business, with a portion of the payment coming back to the person who influenced the decision. This exact scenario—money passed back as part of an arrangement or under pressure to steer the transaction—fits the definition of a kickback. It’s a prohibited practice because it corrupts decision-making and can drive up costs or compromise care.

Upcoding and unbundling refer to billing schemes that misrepresent the level or components of services to obtain higher payments, while fraud is a broad term for deception in billing or operations; kickback is the specific term for returning money as part of an improper agreement to influence referrals.