4 ms·
> Most of these doctors would encourage the staff/volunteers who do the billing to put as many relevant billing codes as possible in the system Is there any wa
by cddotdotslash 4y ago
> Most of these doctors would encourage the staff/volunteers who do the billing to put as many relevant billing codes as possible in the system
Is there any way to fight back against this? I've personally experienced getting a bill after a routine office visit with tons of charges I didn't recognize and procedures they absolutely did not perform. In some cases, it equates to $0 after my insurance pays, but in others it results in quite a bit of extra expenses (especially since I'm on a HDHP).
- droidist2 4y agoThe insurance company probably has a hotline you can call to report medical billing fraud.
- JohnBjorge 4y agoI've worked in the healthcare tech world (for both providers and payors) so I can comment a little here. There's a difference between "billing to put as many relevant codes as possible" and "billing procedure that were not performed". The former is perfectly acceptable, the latter is not and would be fraud. It's possible it was in error, billing is super complicated so I'd recommend just trying to get ahold of the clinic and talk to them first. There has to be supporting clinical notes for anything that gets billed. There are companies/researchers that try to find large scale fraud and then pursue legal action under the False Claims Act (if they win they get up to 30% of what is recoverable) https://en.wikipedia.org/wiki/Medicare_fraud#Medicare_fraud_reporting_by_whistleblowers https://en.wikipedia.org/wiki/Medicare_fraud#Medicare_fraud_... There are also companies that try to help maximize billing. Really they're just trying to bill for everything that occurred, they aren't doing anything exploitive necessarily.