Medical billing fraud ..how to fight

[Rajnikanth]

3 hours ago, dasara_bullodu said:

Idi legal fraud la undi

+1 

ltt on monday man

[SirRavindraJadeja]

Legal fraud aina..they should show u isthe proof of lab tests.

TThey never did

 

And 8 weeks tharvatha bills pampi this is second notice antunnadu..

[SirRavindraJadeja]

OpLegal fraud aina..they should show u isthe proof of lab tests.

TThey never did

 

And 8 weeks tharvatha bills pampi this is second notice antunnadu..

[SirRavindraJadeja]

Ltt.

[SirRavindraJadeja]

Service Unbundling

Unbundling happens when multiple procedures meant to be billed in a package deal are billed separately, therefore creating a higher invoice.

Unbundling is another form of upcoding, also called “fragmentation.” This usually affects patients who have Medicare and Medicaid, since both typically offer special reimbursement rates for specific groups of procedures commonly performed together, such as blood test panels that need to be sent out to the lab. Health care providers attempting to fraudulently increase profits may remove the the special package rates and bill each component of the testing separately.

[SirRavindraJadeja]

Abusive billing4 should be brought to the facility’s attention immediately. Go through the normal channels of reporting errors in billing, beginning with the billing department. If you have no success here, request the contact information of the facility’s Chief Financial Officer.

Sometimes, just requesting this information is enough to rattle a billing employee into action, but if not, follow through with the threat of going to the CFO. If you are uncomfortable doing so, contact a medical billing advocate to do this for you – they exist to help you through situations such as this.

If you have experienced a true healthcare provider fraud scheme, contact the fraud investigation bureau of your state. The National Health Care Anti-Fraud Association (NHCAA) lists the different Insurance Fraud Bureaus by state here.

If your physician is involved in the medical billing fraud you are reporting, you should also alert your state’s medical board to report suspicion of unethical or fraudulent practices. The Federation of State Medical Boards lists the nation’s medical boards by state on this page.

If you are a participant in the Affordable Care Act, you can report suspected fraud by calling 1-800-318-2596.

If you are covered by Medicare and your billing statements do not match, first contact the provider for answers. The billing department should try to help you understand anything on your bill that does not make sense to you and correct any billing errors. Report suspected Medicare fraud to 1-800-632-4327.

All too often, it’s necessary to be persistent with the billing department in righting any wrongs on a medical bill. If you are not satisfied after reaching out to the billing department or if any billing issues are left unresolved, enlist the help of a medical billing advocate.

[Bangaaru]

11 hours ago, SirRavindraJadeja said:

Legal fraud aina..they should show u isthe proof of lab tests.

TThey never did

 

And 8 weeks tharvatha bills pampi this is second notice antunnadu..

Post doctor details and email receipt, I will fight for them 

[BUDDY]

22 hours ago, SirRavindraJadeja said:

Hello friends.this happens to my friend so asking here..na advice already ichesanu

Went to doctor in January 23rd..2016

So doctor who is desi aunty ..avasaram lekapoina blood test teesindi

Regular casual checkup ki velthe

 

Blood test lo hiv..hepatitis etc 5 checkups vunnai

 

They never gave my friend test results.. after 7 and half weeks... Yes after 60 days...bill pampinchindhi doctor.. in that bill health insurance cover ayindhi kaka..non covered insurance 15 dollars pay cheyamani

.friend paid 15$

 

He still not recieved the lab results

 

Now twist is..friend recievd new bill for 650$ next day from a private lab.. they said ..it is second notice 

 

That lab never sent a first notice.

 

And neither they did lab results.

 

They say doctor found some thing that need extra test and so desi doctor sent that private lab their sample for further diagnosis.

 

Now this shady lab also claims that insurance is not reachable hence friend have to pay 650$

 

This shady lab never reached insurance

 

They don't want contract rates from insurance hence cheating and falsy claiming full money.

 

My friend had no serious issues nor even fever..

 

I am 100 percent sure they didn't even do lab test..

 

So desi doctor hospital and this private lab combined doing scam.

How to report this.. how to handle further ?

http://www.nj.com/news/index.ssf/2015/03/salesman_pleads_guilty_in_blood_lab_scheme_that_sn.html

[phatposts]

Naaku ilanti situation lo experience ledu. Kaani ee communication chesina written record unde laaga choosuko. Phone lo matladinavi matter ki vache sariki lekka lo veyyaru. 

Everything via email, certified mail (with signature confirmation if possible). 

Good luck!

[prabhu_pramod]

Every Insurance proivder will have a fraud and abuse department, call them and provide details.

[SirRavindraJadeja]

Ltt

[Rajnikanth]