Hospital Billing Fraud

How or where can I find answer to questions about possible insurance misrepresentatin or fraud by an employer?
I have discovered that I wasn’t covered by medical insurance when I was supposed to be by my employer. Money was taken out of my check weekly to cover the premiums, I had been insured for over a year with this employer at the time and I didn’t recive any notice of a lapse in coverage. I realised after receiving unpaid bills from my doctor’s offices for annual check-ups, that my employer had let our policy lapse. My employer immediately cut me a check to cover the bills and my insurance premiums were paid. From what I can figure, I was not covered and unaware of it for 2 months. That was over a year ago, and now I think it has happened again. I also think my employer is going to drop our insurance policies altogether and I was wondering how much advanced notice they are required to give?
I live and work in Missouri and am very worried about what my rights to coverage are!

healthcare billing fraud

My wife’s HMO just sent us a summary statement of medical care bills and payments for all of 2008.

You tell me — doesn’t this amount to grand fraud?

1. total charges [excluding double billing caused by HMO delaying for months] 33,343.80

2. Allowed by contract [also includes 437.37 that hasn't yet been been ruled as allowed or denied] 8312.78

In other words, the amounts “billed” by the hospitals, lab operations, physicians, clinics, radiologists, etc. were FOUR times the amounts they’d actually agreed to accept as full payment from the HMO.

Now, if you didn’t have an insurance company bargaining for you, the hospitals, et al, would be trying to collect FOUR times as much from you as they really expect to get, and really “should” get.

FOUR FREAKING TIMES AS MUCH !!

***
Aside: for everyone who asks in these forums about paying their medical bills — the bill is a fraud. Provider never expected to get anywhere near that much. Don’t pay it. Offer them far less — it’s all they every expected to get anyway.

[The public hospital was the worst -- billing at FIVE times the amount they'd agreed to accept. By comparison, the regular doctor was only billing 1.6 times the allowed amount. Specialists were billing from two to four times the amounts they'd agreed to.]

***
Now, if your banker was billing you for FOUR TIMES as much interest as he actually expected to collect, you’d call it fraud, wouldn’t you?

And isn’t it just as much a fraud when the public hospital district bills at FIVE TIMES what it expects to get — and then sues the poorest people [who don't have insurance] for the WHOLE FREAKING AMOUNT?

Ye Gods above — no wonder unexpected medical expense is the leading cause of bankruptcy in America. Most of the bills are frauds from moment one.

physician billing fraud

ok i saw this add on the penny-saver, that said comouter jobs i called. and its a training course for medical billing n coding. its 2 weeks long n its from 1-5pm mon-fri. n they have job placement as well. he tol me they place u in either hospitals or a dr office. u get ur diploma and Two certificates in microsoft word and excel and the other ni medical billing. the fee is 2250 but i dnt start paying them until im working already n its in payments of 99$ a month,. how does this sound to u,? and the reason im actually looking into this its cus they said in this feild ill start off getting paid 15$ an hour n im 18 n a have a 4month old baby so i need the job n money. should i go for it?? or do u think its a scam?
10 minutes ago – 3 days left to answer.
Additional Details
8 minutes ago

the outside door to that building said its called ” Gendarme Institute” can sumone look that up for me, but i think its a financial aid type of thing
8 minutes ago

oh n it says “computerized Medical Billing
4 minutes ago

i dont have to pay anything up front> i dnt pay a single dime until ive gotten my certificates n they get me a job n have my first pay check!

health care billing fraud

I have bad credit from medical bills. I always wanted a “credit card” come to find out someone opened a target card in my name- and charged a couple hundred dollars and now they are after me to pay them. I am wondering and I know this is wierd, but now I am more screwed….Can i try to negotiate with Target to get the card back? I want the target card, i’ll pay the bill. I think paying the $200 is worth it to have the card to actually use. i dont know how long it has been in collections, but when i moved here to my new place about 6 months ago i started to recieve phone calls and letters. Or is it better to just report it as fraud? what will that do to my credit? They said it wasnt an application that someone filled out. It was an offer on a reciept that i threw out offering the card with just a signature or something-which is odd. thanks in advance!

physician billing fraud

I’ve worked in insurance & the medical field & the fraud that goes on is a huge cause of high ins costs. More should be done to crack down on the people & institutions committing the fraud.

In the hospital I worked at, during a surgery case you maybe used two strips of elastoplast to hold a dressing on. The patient is charged for the whole role. This was also the case with regular tape.

My friend had a C-section & had to pay it all for lack of ins. She went over the bill & got $700 taken off it. They had charged her for a certain medication 3 x a day & she only took 2 pills. They charged her for sitz baths for her episiotomy, which she never had because she had a c-section. She found a few other discrepancies also. If you don’t see your bill, your ins co may be being charged for things you didn’t even receive.

People who milk dbl and workers comp claims are ridiculous. They don’t show up for exams causing more paperwork, etc., all costing money.

medicaid billing fraud