Mary N. asked:

I am uninsured and need health insurance. I am middle aged and and have some preexisting conditions. My credit isn’t the best due to some fraud I had to deal with and I don’t have much money to spend. Please, does anyone know where I can turn? I live in Texas. Thank you!

medical billing courses

f1Girlie asked:

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

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

j man asked:

It now costs over $400 per month for the average group medical plan that has a $500 deductible and then only covers 80 percent.

Say you have a major trajedy, your still screwed, you’ll deal with in network, and out of network people, some will pay others differenetly, you could still wind up paying 60% of the bill, that is after all the costly monthly premiums.

i just like how they fight to not have to pay anything on claims.

medical billing programs

michelle j asked:

Is it insurance fraud to list someone as your husband on your health insurance when you have been together for 9 yrs and have 3 children together? we just never got married and i do pay for it out of my check bi-weekly…

medical billing companies

Career Adolescent asked:

This is bad, real bad for me I really need some advice from someone who is a medical professional in the area of pharmacy or dispensing of medications. I suffer from AADD and narcolepsy along with disassociates disorder (multiple personalities). I must take a rather high dose of Adderall each day in order to remain functional. I have been on this drug for almost ten years and in that time my dosage has been gradually increased to what it is now. Before Adderall,it was Dexedrine and I was on a very high dose of that also.All along in these many years my health insurance paid for my medication,no problem.Recently however,they are threatening my doctor with legal action if he doesn’t stop prescribing this medication for me.They have accused him of over prescribing and malpractice.They also said they were going to investigate him and have his licence to practice medicine revoked.They came just short of accusing him and ME of insurance fraud.

medical billing company

lee c asked:

Can’t you imagine an America with no poverty, free health-care, free college, no terrorist, no voter fraud, trustworthy politicians and no greed? Which of these has Obama used to capture your imagination? Ask yourself what has Obama done in his life to prove to you he can build this great society other than being a democrat?

medical insurance billing and coding

Cassandra asked:

ok, first of all I work for a doctors office as a receptionist. a while ago I was on myspace looking at one of my friend’s profile, and you know how one profile leads, to another, and so on. Well, I see one of my patient’s profile ‘jane doe” and i notice that she has a different name, then i realize that she has a twin sister but a fatter version claims to be “janice doe”

point is…i think my patient “jane doe” is using her obese twin sister;s (janice doe) insurance!!

what do i do? should i report my suspicions to the insurance company or my boss? but im also afraid that my boss might not care in fear of loosing money….i would

anesthesia billing

Zak S asked:

I’m a full time student that technically doesn’t live at home. I made $30k last year. Do my parents need to claim me as a dependent in order for me to stay on their health insurance (Blue Care Network)? Because i thought the only stipulation was that i had to be a full time student. Because the difference in my return checks would be like $3000 which is a lot, but if my parents have to send anything in to the health insurance company *which they never have and im 21* i don’t want them to just drop me, but i also don’t want to get charged with fraud.

hospital management system

momof2 asked:

True Scenario:
Go to Physician
He is employed by the hospital you work for.
Your insurance is through that hospital, your employer.
The physician has signed a contract with and is a preferred provider for your insurance- as your PCP.
You have a health condition that requires you to receive the pneumonia vaccination every 5 years.

You go to Dr.s office and they tell you the vaccine is not covered by your insurance. The cost will be $120.

You decide to go home and verify (5yrs ago it was covered same doc/same insurance)
The insurance company says it is covered.

You call the physicians office. You get the Tech. They say that “it is covered but they don’t pay me enough to do the shot. So we don’t use the insurance on that. You must pay the $120.”
Now another patient, with medicare, gets same shot- his insurance is filed. He pays nothing.

They (office manager) say they have the right to do that on items that would not make a profit.

Um- I thought thats why we had insurance?

health care billing