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Apr 30, 2024
2:22:48pm
Black Diamond Bay All-American
I'm trying to figure out how exactly to go about resolving a fraudulent billing incident with my kid's pediatrician.
I got a bill after a well-child visit. I called the insurance company and the first person I talked to said that she wasn't sure why there would be a balance because well-child visits are covered at 100% and sent it back for review.

It still wasn't paid, so I called back in again today to the insurance company and they said that there is a balance because it wasn't coded as a well-child visit. The pediatrician double-billed as a well-child visit, as well as a "problem focused visit" because of a minor issue that was noted during the visit.

I'm trying to decide if I send a message directly to the pediatrician, or to the health system's billing department (I've been on hold with them for 90+ minutes now), or I guess I could just jump straight to reporting her to the state for fraudulent billing, which I kind of want to do, but it does seems like maybe I should try to find a more reasonable solution first.

In my chart the visit notes say that it was a well-child visit with "no abnormal findings."
Black Diamond Bay
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Black Diamond Bay
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Mar 4, 2003
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May 20, 2024
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8,231 (164 FO)
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