Hospital 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.
My boyfriends mom is having a major back surgury done in February. She had a person donate $10,000 to her for the expenses. She has all the money that has been donated and earned in a medical account, with her friend who is also on the account. She will be out of town for about 2 to 3 weeks, and she decided that it might be useful for her to have a laptop for research and bill paying. She used some of her medical money for this. Her friend called her in hysterics telling her that it was fraud and that she had to send it back or else she would take herself off the medical account and she wouldn’t go with her.
Is buying the computer really fraud? She’s willing to send it back, if she’s going to get in trouble, but not just because her friend says she has to. She has other people to go with her, and that she can put on the account.
Thanks
–Julie ?
As I said, She is willing to send the computer back, and she didn’t know that she wasn’t supposed to buy the laptop with that money, because it was donated by all family, but she was just wondering if that was just her friend being dumb, or if she was right. She will send the computer back immediately.
Sorry guys!
the donations were made to cover ALL costs, not just medical bills. that’s why she didn’t know it would be fraud

hospital billing regulations

I am engaged to be married later this year. A few weeks ago, my fiance was in an accident which required 3 spinal surgeries and over 2 weeks hospital room and board. He is attempting to get Worker’s Comp to pay this case as it was work related and also is applying for medicaid in the event his claim is denied. To make a long story short, both me and his mom claimed him as a dependent (don’t know why she did when he lives with me) and Medicaid is calling this fraud, we were assured that he can reapply with his proper information (my address) and this will go through…

My question is… if workers comp and medicaid both deny his claims (unlikely but possible) when we marry later this year will I then become responsible for his incurred medical costs even though I am not legally his wife at the time of the accident?
I claimed him as my dependent to Medicaid in order to prove he was financially incapable of paying. He has no income and I support him which is basically what I had to say in a letter.
Medicaid considered it a “fraud” application because his mom also wrote the same letter – even though she was told not to — LONG story but I am getting a Marie Barone wanna be for a MIL

hospital

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

Hi, I had many credit cards, medical bills, and utility bills opened in my name and social security number. After these thieves opened the accounts and got what they wanted, they started sending the bills to me! My once good credit is now in shambles. I have filled police reports, called the companies, and contacted the credit bureaus to dispute the items as fraud. BUT, I keep getting the bills, and the credit bureaus are saying that these are “validated” as mine!!! I just want them off my credit report. I have sent out police reports, I have sent all the information that everyone has asked for, and no one is taking anything off my credit report. Please help me, the credit bureaus will no longer let me dispute any of these false items and I’m getting desperate. Thanks

medical billing management