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Apr 30, 2024
2:52
:12
pm
Jesse Pinkman
All-American
and then they send you to collections and it messes up your credit
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Jesse Pinkman
Previous username
QuickCoug
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Jesse Pinkman
Joined
Feb 6, 2002
Last login
Jun 13, 2024
Total posts
20,441 (36 FO)
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Messages
Author
Time
I'm trying to figure out how exactly to go about resolving a fraudulent billing incident with my kid's pediatrician.
Black Diamond Bay
All-American
Apr 30, 2:22pm
Give me a break. Could you be more ridiculous?
cougfanz
Apr 30, 2:27pm
It was billed at $700, and I wasn't able to get anyone to answer the phone when I called the office directly.
Black Diamond Bay
Apr 30, 2:29pm
Go for it then. But your doctor likely has zero control on who’s staffing the
cougfanz
Apr 30, 2:31pm
The well-child visits are charged at $142 actually, and who else do you think it is that is putting two visits into the
Black Diamond Bay
Apr 30, 2:34pm
I’m not blaming you for being angry/annoyed. Medicine just sucks.
cougfanz
Apr 30, 2:37pm
Sooo....who do you think it was that submitted that bill for a second appointment?
Black Diamond Bay
Apr 30, 2:42pm
Any coder can submit whatever code/charge they feel the documentation
cougfanz
Apr 30, 3:01pm
While that sounds reasonable, she's part of a healthcare system so any billing questions now have to be routed through
Black Diamond Bay
Apr 30, 3:11pm
You can bill a problem based E/M visit ( the problem that requires referral)
cougfanz
Apr 30, 3:23pm
I have received referrals at visits in the past without being billed for an additional appointment, at a significantly
Black Diamond Bay
Apr 30, 3:38pm
So you admit more was done than just a well visit for one child.
BLT-Coug
Apr 30, 3:04pm
No. That was a separate visit. I was giving you anecdotal information to indicate that she's an aggressive biller.
Black Diamond Bay
Apr 30, 3:12pm
RE: The well-child visits are charged at $142 actually, and who else do you
imdocrob
May 1, 10:03am
Sounds like you're frustrated at the wasted time and want to punish someone
Tricky
Apr 30, 2:56pm
Yeah, pretty much. This is not the first time I've had to spend hours on the phone to sort out some inept billing
Black Diamond Bay
Apr 30, 3:02pm
how much of that $700 did the insurance actually allow?
qwerew
Apr 30, 3:05pm
The insurance paid $376.07, they want another $100 from me.
Black Diamond Bay
Apr 30, 3:13pm
that does seem like a lot extra if it really was a quick, easy "minor issue".
qwerew
Apr 30, 3:15pm
She didn't do anything. She gave me a referral to a specialist.
Black Diamond Bay
Apr 30, 3:23pm
well, you might be surprised how much time and effort the Dr. and staff spend on
qwerew
Apr 30, 3:34pm
Sorry - 99% of the time you get the run around from insurance & the doctor
BYU Fan
Apr 30, 2:34pm
You paint a picture of doctors who have no control over their practice and rely on patients to make them bill correctly
Bobber
Apr 30, 4:22pm
We don’t have control. We don’t own our practices.
cougfanz
Apr 30, 5:38pm
Somebody does, and they should not rely on patients to make them bill correctly
Bobber
Apr 30, 9:57pm
Welcome to healthcare.
D.T. Survivor
Apr 30, 6:06pm
When Walmart, Google, Berkshire Hathaway, Amazon
cougfanz
Apr 30, 7:40pm
Amen. Insurance and government are the biggest reasons it’s a mess IMO
D.T. Survivor
Apr 30, 7:59pm
Dentist did this to me. Fight back. Its fraud. Its stealing. Anything is
Wife_Apologist
Apr 30, 2:28pm
Dentist did what exactly. Please explain in detail.
kotacoug
Apr 30, 2:30pm
Posted about this before.
Wife_Apologist
Apr 30, 2:33pm
My wife has saved us $1000's by following up on fraudulent medical billings
BYU Fan
Apr 30, 2:40pm
What exactly are the best ways to go about following up? We have a
ossicles
Apr 30, 3:22pm
Sadly you have to devote hours talking with the insurance company & doctors
BYU Fan
Apr 30, 3:30pm
Get documents. Ask for documents. Don't let calls end without them.
Wife_Apologist
Apr 30, 3:32pm
That really doesn’t make much sense. You’ll have to post what procedures were
kotacoug
Apr 30, 3:54pm
I'm not going to go digging for those bills. Dentist ate the charge so he
Wife_Apologist
Apr 30, 4:08pm
What you wrote actually doesn’t show that all, but whatever makes you
kotacoug
Apr 30, 4:41pm
Email is great, found it
Wife_Apologist
Apr 30, 6:29pm
Yes just as I thought…. D4346 is a code for a procedure when there is a lot of
kotacoug
Apr 30, 8:09pm
I don't know understand who is sending you this bill but just call and say this
rcbyufan
Apr 30, 2:41pm
and then they send you to collections and it messes up your credit
Jesse Pinkman
Apr 30, 2:52pm
Ha, if it were only that easy
vegas guey
Apr 30, 3:26pm
I used to try and slip non wellness check up issues into the annual visit as well…
touchdownbyu
Apr 30, 2:52pm
Majority of drs don’t even do their own billing. Likely an honest mistake by
GreatestTrochanter
Apr 30, 2:54pm
what seems like a "minor issue" to you is extra time and documentation for the
qwerew
Apr 30, 2:58pm
$700 and hours on the phone "minor issue"?
Wife_Apologist
Apr 30, 3:00pm
Oops my bad. Minor issue was reported.
Wife_Apologist
Apr 30, 3:03pm
could bill 10K doesn't mean insurance allows that amount.
qwerew
Apr 30, 3:07pm
I misread you then you misread me.
Wife_Apologist
Apr 30, 3:28pm
Once again, this problem is because healthcare wants to act like they aren't
rcbyufan
Apr 30, 3:07pm
I tell patients all the time that getting an x:ray or cortisone injection or any
qwerew
Apr 30, 3:12pm
That's a start. But if you aren't telling them how much it costs it is not very
rcbyufan
Apr 30, 3:21pm
Dr.'s don't have that info sitting at the tip of their tongue. I don't think
qwerew
Apr 30, 3:28pm
I'm sorry, how should the doctor be able to bill?
BYU Fan
Apr 30, 3:13pm
Sounds like a lot of CB Drs are cool with skimming money off patients and fraud.
Wife_Apologist
Apr 30, 3:18pm
she clearly stated another "minor issue" came up. $376.07 seems excessive on the
qwerew
Apr 30, 3:19pm
What’s a “minor issue”?
cougfanz
Apr 30, 3:29pm
good question. Just what she stated in OP. Apparently "just" a
qwerew
Apr 30, 3:37pm
I can't imagine what a $700 minor issue would be
BYU Fan
Apr 30, 3:35pm
we can all agree cost of "receiving" health care and cost of "providing"
qwerew
Apr 30, 3:39pm
Most of us are on the side of receiving abysmal customer service
vegas guey
Apr 30, 3:48pm
I hear you. I live on both sides of the coin.
qwerew
Apr 30, 4:04pm
Ok. Now try working for that system AND having to deal with it as a customer
cougfanz
May 1, 8:23am
UPDATE: I spoke with the insurance company again and they transferred me to the compliance department who wants to
Black Diamond Bay
Apr 30, 4:21pm
The system is not a good one, but here is probably what happened. You were billed for preventative services and also
HungryCoug
Apr 30, 5:57pm
So she shouldn’t report the case to the medical board???
kotacoug
Apr 30, 8:12pm
This is ridiculous. It was his 9 month well child check up. We were with the doctor for probably less than 10 minutes.
Black Diamond Bay
May 1, 3:49am
The way the insurance and medical system is set up is ridiculous. You are right.
HungryCoug
May 1, 7:54am
I didn't sign anything during the visit.
Black Diamond Bay
May 1, 9:43am
I misunderstood one of your previous posts, sorry. The rest of my reply still stands. It’s understandable you’re frustra
HungryCoug
May 1, 10:41am
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