revutap t1_iujnl48 wrote
Now my question is, how many times has her husband's private practice that she's overseeing done the same thing to other poor innocent families who doesn't have the same skillset as her to not only recognize the erroneous bills but successfully argue on their behalf?
Seraphenrir t1_iuk6nyg wrote
Private practices of a solo or small group of physicians aren't the same thing as large corporate ER's/Hospitals. Speaking as a physician, if you screw your patients with large surprise bills, they're going to quickly lambast you online and switch to another physician. Not exactly the best way to build a successful business. Private practices generally are for specialties that typically deal with elective complaints, where the problems aren't urgent and you have a choice of who to see. Whereas if you're a large ER or hospital, most if not all of your patient's are in some sort of emergency or urgent condition and don't have any choice but to be in your hospital, without much say in the matter.
We get little to no training on how to bill for our services in medical school or residency. Most of the time we have to get lectures on how not to underbill for what we're doing.
The other point to consider is that fraudulent billing is serous. The fines are repercussions are massive, including being cut off and banned from those insurers or Medicare/Medicaid entirely.
revutap t1_iuk71m3 wrote
Thank you for your response. I’ve learned something.
[deleted] t1_iujnyul wrote
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[deleted] t1_iujoqcg wrote
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upstateduck t1_iujrnyk wrote
exactly, the common "billing consultant" advises doctors/hospitals how to maximize their revenue through manipulating codes for payment
ambulancisto t1_iuk8kd9 wrote
Not much I suspect. Do that with a Medicare patient and you fall under the False Claims Act: a civil war era law that punishes people who overcharge (i.e. defraud) the government. It encourages whistleblowers to turn in their companies/bosses, because the whistleblower gets a cut of the recovery. I saw a doctor get fined $800k, plus had to pay back all the profits, for ordering nonFDA approved chemo medicines from Canada to give to his patients. I'm sure someone in his office turned him in.
BaronCapdeville t1_iujq6vf wrote
Ok.
Why is this your question?
revutap t1_iujqfk9 wrote
Because of the lack of transparency in medical billing. I simply have my own personal doubt that this is not something that has been done at their own family practice.
I am not looking for you to think like me nor agree with my line of thinking.
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