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HadesHimself t1_iujwnf8 wrote

Reply to comment by killshelter in A billing expert investigated her husband's ER bill. She was able to knock thousands off the charge. by 11ej25

Fraud requires intent I'd guess right? Hospital can easily claim it was an honest mistake on their end, which they corrected when the couple notified them of their mistake. We'll never know whether it was truly accidental of course.

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boadicea-h5 t1_iujz9lb wrote

It does require intent. I'm a medical coder and biller. We make mistakes. If we are notified and correct it, it's not fraud. Typos happen. We are legally obligated to notify insurance companies of these mistakes so the medical record they have for the patient is corrected as well. It's very easy to make a mistake. We try not to, though.

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Rikuskill t1_iuk0whj wrote

I just wish there was some more transparency in this situation. It shouldn't have taken a year to discover the fraud. The data should be quickly available, and if not then the charge should be dropped, no?

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