6 ms·

Billing is done largely manually, there is a lot of room for human error.

• wyldfire 7y ago
  No way, this was totally deliberate fraud. The physician likely included all of the accompanying diagnostic codes for ultra rare/serious symptoms/history so it wouldn't get rejected by the insurer. Plus when asked for an explanation by the reporter they didn't opt to fessing up to a mistake or explain why the charge was necessary: they offered no comment whatsoever. Their fraud relies on insured patients not reading EOBs (because many of us don't).
  • OnlineCourage 7y ago
    Fraud on the part of the practice, yes possible. The parent comment seems to imply the payer is at fault or committing fraud.
    • EamonnMR 7y ago
      I thought it was obvious so I didn't spell it out, but yes this is the practice defrauding the insurer.