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 !!

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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.]

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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.

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Fraud. Theft. And the blind leading the blind in Government managed
medical care. MEDICARE and MEDICADE. If you stopped these
two factors involving The above. You could afford to cover every man
woman child in this country with the best care in the world. But he
will not go after the failed entitlements of the Democratic Past.

Whats your thought America.

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Many people seem to be for a national health plan that will be written by non-medical politicians and will be a monopoly on health care that limits ability to have access to medical attention not covered by the plan.
Is it possible to have our government write a plan that will not guarantee high profits to those who donated large sums to a candidate’s campaign?
Will the plan eliminate (or at least address) Medicare and Medicaid fraud?
Will the plan continue to pay the high salaries of non-medical CEO’s who own health care facilities, testing centers and treatment centers?
Will tax payers be expected to pay higher land/homeowner taxes making owning a home impossible so that non tax payers can continue to have better health coverage than those who pay taxes and own assets that must be depleted if one needs medical care?
Will our national leaders get the same coverage as everyone else if a national health plan is started? (Will legislators get the same limitations as tax payers who vote(d) for them?)

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I like his ideas regarding herbal and alternative medicines, but I am concerned about the eldery in United States. They seem to have been neglected in favor of “welfare” recipients.

I am sick of welfare fraud and abuse of medical care in this country – who is looking out for the eldery? The dems give it minorities, welfare lifers, etc., rep create more paperwork and increase costs…

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The high cost of Medical Care would be cut tremendously if the greed, fraud and abuse was taken out of it.

But yet most Americans want the taxpayer to pay for all of it.

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