Hospital Billing Fraud

Spock (rhp) asked:

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

~*JaYDens PrETTy MoMMy*~ asked:

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

Jungle Princess asked:

into my account? It’s a long story, but to make it short – my sister stole my identity and used my name and SSN to charge up thousands in medical bills. The hospital bills started coming to me after the hospitals located me in my home state. It was a big mess to get sorted out and nearly cost me my good credit. I chose not to press charges against my sister although I did tell the hospitals she was the one who commited the fraud. A few weeks later, I inadvertently recieved in the mail a small ($250) check addressed to her from a very old car accident. There was no way I was going to send her this lttle surprise after what she’d done to me so I put it in my account. The stupid person who told me how to do that ended up telling someone who told my sister (double betrayal) and now she told that person (she doesn’t have my #), to tell me she is pressing charges. Of course I can press charges against her for her far worse crime! However, does she even have a case here?

medical billing program

Innocent asked:

Other than putting an end to the war.

Would putting a stop to government employee theft, fraud and abuse be a good start. Another one could be putting an end to fraud and theft by doctors, hospitals, drug companies and health care providers.

What other areas do you think would be an alternative to tax increases.

medical billing service

freedom_rulz@sbcglobal.net asked:


I stayed at a hospital for three days in November. I have a $1500 deductible which I have not met yet. My EOB (Estimation of Benefits) said I may owe $2200 (out of $6000) — most of that $2200 includes my deductible and co-insurance. However, when I recdived the bill a month ago (around December 15th), it shows that I owed only $58 and, according to the itemized bill, most of the $2200 I owed was written off. Is this possible? Or does this sound like an accounting mistake? (My mother-in-law, who knows a lot of people who work at that hospital, will be checking it out this week.)
1. I’ve had outpatient procedures at this hospital and I can tell you that they have not written off a huge amount like this — some, but not a huge amount.

2. About two years ago, my dad had gallbladder surgery at a different hospital. Out of the $25,000 he owed, insurance paid $15,000, but he ended up owing only $1,000 because the hospital wrote the rest of this off.

3. Do hospitals tend to write off big bills that are processed towards the end of the year — for tax purposes?
I am on Blue Cross/Blue Shield BlueOptions (PPO) with a $1500 annual deductible. They have a contract with this hospital.

medical billing association