marche_au_supplice t1_jdapobw wrote on March 23, 2023 at 1:07 AM

Reply to comment by bluethread32 in Successfully Reduced YNNH ER bill? by bluethread32

Is that in line with what you’d expect your insurance to have covered?

bluethread32 OP t1_jdaqgn3 wrote on March 23, 2023 at 1:13 AM

It's in line with the percentage I expect my insurance to pay.

But the total bill ($3200 pre insurance) is not in line with what I expect for a visit that has no imaging, injections, specialists etc.

Just examination, and then gauze applied with medical tape and ointment.

britishbeercan t1_jdauudb wrote on March 23, 2023 at 1:45 AM

Did you actually see a physician? Yale very frequently has you see a midlevel with far less training/education and then has the physician sign the chart later without ever seeing you. If that happens, you can claim fraud, billed services not rendered, etc.

This is probably more common in the adult ER than the pediatric ER however.

bluethread32 OP t1_jdav3t0 wrote on March 23, 2023 at 1:47 AM

They had me go through every level.

Triage, student, resident, physician (I am assuming the last person was the physician but they ask introduce themselves as Dr so I don't really know)

marche_au_supplice t1_jdb20rr wrote on March 23, 2023 at 2:39 AM

The resident would also be a doctor and introduce herself as such

bluethread32 OP t1_jdb3m1u wrote on March 23, 2023 at 2:52 AM

Thank you.

There wasn't much paying attention to intros going on. I had an energetic/injured toddler and the ER was packed with sick kids.

They were all kind FWIW.

Darwinsnightmare t1_jdckxeh wrote on March 23, 2023 at 1:04 PM

The physician can sign the chart of a patient seen by a mid level and it is not fraud. It can also be billed fully at 100% if it is coded as a simple case, and at 85% or so if it is a more complex case (and the MD didn't see the pt). What you're saying just isn't true. It's only fraud if the physicians attestation falsely claims that they actually saw the patient and they did not.