Medical Billing Complaints

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Medical billing complaints are on the rise and with very good reason. Over 80% of medical bills contain errors, whether from erroneous charges, double billings or, in some cases, abusive charging practices. It’s no wonder that patients are finding it difficult to trust their hospital or physician to charge fairly for their services.

 

Why Billing Complaints are Increasing

medical-advocacy_108321947Medical billing complaints are increasing for several reasons. Now that physicians and hospitals are using electronic devices, more errors are being made. Some hospitals and physicians are attempting to increase their profitability by using more creative billing code practices. Whatever the reasons for the mistakes on the bills, patients are paying far more than they owe in most cases.

Many errors are made with electronic patient records by checking the wrong box or entering a wrong number.  The billing department uses the electronic patient records to bill the patient and any typos, will be carried along into the patient’s bill. To make matters worse, the patient usually never sees a detailed bill so they have no idea there are mistakes on that bill.

Some hospitals use billing codes that cost the patient far more to increase their bottom line.  For instance, instead of using a billing code that bundles many aspects of a procedure, a facility might use the billing codes for each part of the procedure.  This method, often referred to as “unbundling”, charges a much higher rate for a procedure than using the bundled billing code. Many medical billing complaints have been lodged against hospitals for this practice.

Medical facilities might also use other creative billing practices that generate medical billing complaints.  An emergency facility might charge for a higher severity level than was actually assigned. Treatment for a minor injury would not require the use of life-saving equipment, which can incur high charges. However, you could be charged for the use of a high severity level room without your knowledge.  Without a medical bill audit, a patient will have no idea they have been improperly billed for that emergency room visit.

Numerous medical billing complaints involve procedures and services appearing on a patient’s bill that have not been performed. Patients have been billed for the wrong procedure or for the correct procedure but a much more expensive version of it. They’ve been billed for services or tests they did not receive.  Sometimes the patient is charged for another person’s medical procedure due to confusing patients’ names.

 

It Pays to Get a Medical Bill Audit

With medical billing complaints on the rise, every patient should get a medical bill audit whenever they receive a medical bill they feel might be incorrect. Over 80% of these medical bills contain errors and can cost the patient many thousands of dollars.  Only with the help of a medical billing expert can the patient find out the detailed charges on their medical bills.

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53 responses to “Medical Billing Complaints”

  1. I struggle with HENRY FORD HEALTH SYSTEMS constantly. We send them payment via Chase Banks Online payment . This last one was held for a month before applying it to the bill which had become substantial because past attempts to pay thru my HSA were kicked out of their system claiming they didn’t have some piece of data, it varies depending on the event. We spent 45 minutes on hold trying to sort it out , were given the required information to pay the account then they DID IT AGAIN! I’ve never known a hospital system claiming it wants payment kick so many of them back. Then they report YOU to the collection agency.
    Separate issue with United Health. Therapist Associates swear they send bills to UHC 2x a month. My March bill was for $24. April, they bill me $702. UHC goes all the way back to Oct 13 with refused claims, some of them I swear I paid in Dec. Do they double bill clients?

  2. Elizabeth Downs says:

    I recently moved, and contacted a new doctor, he said he had to refer me to someone else, he wasn’t specialized in the area I needed……..received bill for $300.00 for nothing! Then went to the doctor he referred me too, that doctor said he needed my records from where I moved, did nothing! Received Bill from him for $300.00……..this is crazy I have’nt even been helped yet after $600.00 later! Need Help!

  3. Floyd Smith says:

    I took my daughter to the Tennova emergency room in July of 2012. Tennova filed with Bluecross and on 8/1/12 Bluecross said it was out of network and I owed the entire amount just over $1,500. Tennova then sent me a bill on 8/20/12 showing they reduced the bill by just over $1,200 and billed me $340. I had a payment plan for 2 other visits at the time and Tennova rolled the $340 into this plan which I paid off entirely by Apr/May of 2013 according to their schedule.

    Then in Dec of 2013, Tennova (Bluecross says they didn’t do this) resubmitted everything to Bluecross claiming that it was a true emergency and thus should have been treated as in-network. Bluecross agreed and paid Tennova a bit over $500.

    In Feb 2014, I received a bill from Tennova saying I own them an additional $695. I and the benefits group that the company I work for gets our medical policy through have been talking with the Tennova billing department about this and getting nowhere. And to top it off, I now received a letter saying I own them over $1,300 for the service and if it’s not paid in 10 days will go to collections.

    I’m at a loss about how to go about getting this resolved. What should I do?

  4. […] costs are likely unjustified, as billing errors have become alarmingly common. According to the Medical Billing Advocates of America, 80% of hospital bills contain at least one […]

  5. KJCO says:

    Hello,
    I’m struggling with a medical bill from doctor I have never even seen or spoke to. I had a scheduled surgery in local surgery center. During the surgery my gynecologist called in general surgeon for consultation and he ended up taking my appendix. I woke up from my surgery – actually 2 and was sent home.
    Everyone got paid by my insurance company as in-network surgery. This particular doctor that took my appendix billed his services as emergency and out of network. And he billed me for the difference between his inflated rates and what the insurance paid him. I never requested him, met him or spoke to him before or after!
    He had multiple tax ID numbers and sometimes he is in network with my insurance, sometimes he is not. He is claiming that that day he was out. He already got paid more money then my gynecologist for hysterectomy. He offered to cut his bill in half if I was to pay him cash ( before my insurance paid) After my insurance paid, he just send me bill for the remainder of the full amount.
    He sent this to collection at this point. I disputed this with them and the credit bureaus. I would like to take him to court but the collection agency has no desire to do that and apparently I can’t do this myself.

    I would really appreciate any idea or suggestion how can I deal with this?

    thank you for your time

    Kamila

  6. Valerie says:

    I have had numerous surgeries and treatment for stage iv Cancer. A year following chemo and radiation a suspicious deep chest lump required a thoracic surgeon to biopsy/remove. It was low activity and surgery was not urgent. I was told by the doctors office staff prior to surgery I would be responsible for 10% and my insurance was “IN Network” and the doctor would accept the contractual amount plus the 10% (approx $805.00) I would be responsible. Total approx $8050.00 doctors bill.
    A month after surgery I received the entire bill over $10,000.00 noting that I was not in network and so they were also not going to honor in network pricing and I was out of luck as now I would have to pay whatever the insurance would not, which they believed would be approximately 50%. ( I have checked with every doctor and this is the first in 4 years) and I would be responsible for anything the insurance did not pay since I was OUT OF NETWORK. I spoke w the insurance and they asks for corrected codes and informed e that this doctors staff knew prior to surgery I was not in network and should have told me the correct info/amount I would be responsible like every other surgeon has done. I was told NOT TO WORRY by the Drs. staff that assured me I was IN Network, I have received a different bill each month anywhere from $805.00 to #11,587.00. The office girls who had spoken with me were terminated and the new staff had told me for 8 months I must pay a billable hour to speak with the doctor regarding his billing. Letters were sent from the get go and again I was told as I received checks from my insurance company assigned to me which I signed over to the doctor within 24 hours that I would not be responsible of more than the 10% so I have been making payments for $80.55 for 6 months ( paying a total of 10 months) although I have been unemployed due to stage 4 breasts cancer and 75 radiation treatment and my 26 yr old daughter is helping me financially. No bill is the same, I am not credited for checks signed over nor personal checks or money sent direct from the insurance company. I have requested numerous attempts to speak with the doctor ( per the billing companies suggestion stating their hands are tied) and the only communication I received was last week when he called stating I had received a %7210. check from my insurance company which is completely untrue and he was trying to help me by not notifying the IRS stating I did not forward that check to him which was made out to me.and he would hate for this to go to Internal Revenue. Late June 2015 (I have his recording) I have requested via certified mail 6x to send me an accurate billing with all credits accounted for and we can discuss a couple small checks made out to me, I am holding until the doctor and his office sends me a correct bill. Every month the bill is different and I am still recovering at age 61 from all the radiation and chemo treatments, unemployed, not arguing my 10% and was diagnosed with HYPERTHYROID in the past month and got shingles which I believe is caused from all their telephone calls harassment and ineptness to accurately bill me as a patient. In fact, he added $2000.00 more to one of the treatments given in the hospital this last bill. I have never heard of a cancer patient, or anyone who has paid all their bills as scheduled because doctors and hospitals advise prior to surgery and what I was told was not the truth. I do have witnesses who came with me to the appointment and can vouch I asked as I always do and was told, I was in network and not to worry. Just take care of yourself and get over your cancer. Can you help! I have all written communications, letters, etc. This week I received a notice that I will go to collections if I do not pay the most recent bill which is higher than all of them. I have paid every single doctor and hospital bill maxing my yearly out-of-pocket and have good credit with no outstanding medical debts and they are threatening me to the IRS and collections. I have been paying my part of the 10% every month and have cancelled checks which they have not credited me correctly. Thank you for your time and energy Valerie

  7. Barb says:

    My husband was sent a bill for tests that his heart doctor stated he did and the only test the doctor did was a blood test and the rest of the test the doctor ordered we cancelled the same day and they still charged us for the test.we cancelled the test per my husbands family doctor not recommended them that they were not necessary to go do a heart cat that would tell all. we did the heart cat on 01/29 by a different heart doctor because our regulator heart doctor could not perform the heart cat in the hospital that our insurance would cover and that heart doctor told us he would send the rusults to my husbands regulator heart doctor. we went to the regulator heart doctor and on 02/5 to see the results. the only thing the doctor did was look at the results and then my husband was charged again for test he never had done. nothing was ever hooked up to him it was only a 10min dr’s visit. after the bill was sent to us we fired the doctor and we have been protesting these bills since last march 2015. our new heart doctor said he use to work for that same heart center(ny heart center) and the doctors were told they were not making their quotoa’s that they had to order and charge patiences for tests not performed to get their quota’s. thats why he left that heart center because they ripe off people.
    what can i do before they turn us into a collection agency for not working with us.

  8. Christie P says:

    When we go to the doctor, we pay what we owe. Every once in a while I get a small bill and just figured there was an insurance adjustment. A couple of weeks ago I got a bill that said that I had a past due amount of $179, $159 within 0-30,$30 31-60 days past due, $89 and over $300 over 140 days past due.
    I called the one who takes care of billing/insurance asking where the $179 amount came from, then I asked why I hadn’t received another bill and why does it show these past due crazy amount? When we see the doctor once every 3 to 6 months for routine stuff, my husband and I ask what we owe so we don’t get crazy bills like this. I asked if she could explain it to me at all, she said ‘Let me move your credits around’. She then couldn’t explain the amounts past due and said I actually owed $225.She was pulling info up from last year up.

    I asked her if she was an accountant or at least had a BA in accounting. She said no. I asked her if she had someone check over her information, she said her office manager checked over it some.

    I love my doctor, I don’t want to change but his billing system has got me rethinking about changing.

    Is there anyway they can be audited to see if they are doing things correctly? When she told me that she needed to ‘Move my credits around’ it alarmed me. When she had no clear answers, I was just stunned.

    How do they get away with this?

  9. Mrs L J Miller says:

    Kettering Medical Center in Dayton Ohio has a billing method that is impossible to deal with. They are the corporate body that bills for many of the doctors in the area. I pay my Copay every time I visit the doctor, but it is typical for them to contact us saying we owe on an office visit from FOUR YEARS AGO, Their creative accounting practices make it impossible to figure out what they did. Any payment we make is added to whatever they want to attribute it to. That means that when they think there’s a problem, We have to dig out records for upwards of four years to prove that we actually paid for that visit. In that time, our insurance has changed, and that makes it even more confusing and difficult.

    There ought to be a law requiring hospitals and doctors offices to put my payment against the bill I say it is paying. Otherwise, they’ll put $12.48 toward one charge, $46.00 toward another, and the rest toward whatever is left over. How am I supposed to keep track of all this crap!?!

  10. Bolor says:

    Hi. I am an international student in USA. I didn’t have health insurance before. One time I had health problem and went to a clinic. The clinic lady sent me to a hospital . I didn’t get help from that hospital even though I was in emergency room. In emergency room they checked my blood pressure, height and weight which I didn’t need and nothing related with my pain. The doctor said there is nothing to do for them, because my pain will get time to heal itself. That’s it. Till today I am struggling in my pain waiting to heal itself. The worst thing I got $2100 medical bill. I can’t understand why they want me to pay this amount? For checked blood pressure, height or weight? It makes me so upset . Now collection agent says If I can pay $1500 , they will finish this bill. I don’t know what should I do, if I got any help I would pay . I didn’t get any help and I am in debt. Please help me

  11. Davi says:

    I _had_ an appointment with the Center for Rheumatology because I had been hospitalized twice. A day before my appointment, a dear friend of the family passed, and he was death #15 in 5 years. Emotionally distraught, I didn’t know when I’d be available to reschedule, so I called the Center and cancelled my apppointment. Then I recieved a bill from them claiming I was a “no show.”

    Unbelievable. Here’s someone in physical pain, on disability and mourning, but they claim it was a no show and bill them *shakes head* Wonderful bedside manner, right?

  12. T. G. says:

    I have an issue with a bill. I received a bill for an outside provider, where my daughter’s blood work was sent. I immediately called my insurance provider and had the bill faxed over. My insurance company informed me that the provider office used a provider outside of the network and that’s why I’m being billed because the insurance company doesn’t have a relationship with that provider. The insurance company stated they sent the provider a letter informing them, that it’s their responsibility to use an outside provider covered under the insurance. I’ve called the office several times, left voice mails with no reply. My concern is this bill, as this is the second notice. I’m currently receiving medical assistance from MEDICAID and can’t pay due to lack of income. At this time I don’t know how to proceed to get this matter corrected. I’m currently in Phila. PA and I’m not sure who I need to send the complaint to.

  13. Sanjay says:

    Hi
    I had an Endoscopy and Colonoscopy done is August 2012 and I received 2 bills from (2 different account numbers) totaling $4000. I was young and had zero knowledge about the medical industry that time and I started to make payments. I still kept bills and today I saw your article and looked in to the bills from 2012. I see both bills charged me for endoscopy and colonoscopy twice. I am making payments to a collection agency now. I still owe them $2000. Is it too late to audit my medical bills from 2012 Aug? Any advise would be greatly appreciated.

  14. Sally Peters says:

    Hi, My husband had a procedure done in the hospital in August of 2014. We had Empire Blue Cross under Obama care. In order for my husband to have this procedure we needed to get authorization from the provider, which we did. It took 4 months of me nagging BCBS to pay the bill. BCBS sent me a check for $1861.00 Jan 2015 along with an EOB stating this payment covered the procedure. I cashed the check and sent the hospital $1861 and the account was considered closed. I received a letter from BCBS March 2016 requesting I pay them back the money because the hospital was already paid prior to me sending in my check of 1861. Apparently the hospital received a check from BCBS in the amount of $1996. In Dec of 2014. $1861 was for the procedure and $135. Was a late payment fee. The hospital is now refusing to give me back my money. I’m being told the original bill was $10,000 and the insurance company only paid them $1861. They state because they are not contracted with obamacare they have the right to charge 40% of the $10,000. So they the insurance paid them $1996. And I sent them $1861. Which they are considering their 40%. What can I do to get the money back so I can give BCBS their money back.

  15. Doug says:

    My wife and I were shocked to receive a $370 bill from our pediatrician for an 8 minute visit with our daughter. We brought her in because she hadn’t moved her hand at all for 12 hours (since the previous night). The pediatrician explained that “nursemaids elbow” is very common in toddlers our daughter’s age and demonstrated the 5-second procedure that pops the joint back into proper alignment. The 8 minute visit required no consumables, medications, etc. – just the one-time 5-second simple movement to realign the joint. The billing code used seems to properly describe the issue: “PR CLOSED RX RADIAL HEAD DISLOC,CHILD” with Code ID: 24640.
    We don’t understand how an 8 minute visit with the same pediatrician we always see (always for even longer visits) can cost 5 times more than our usual visits simply because there is a code? Am I missing something?

  16. Theresa Beam says:

    I had some physical therapy back in 2014. Insurance as billed and paid 80%. 17 months later I received a bill for the balance of $117. Am I liable for this? I now am unable to use my FSA account for this! Is this a common practice? I tried talking to the billing company and they will give no adjustment at all>

  17. Penny N says:

    Hi,

    I had an MRI of the brain without contrast in November, 2015. I had called before and planned to self-pay as I always have done for procedures (at the same facility), because our insurance does not cover until we have reached a $5800 deductible, so we just self-pay for most “sick” visits or procedures. I was told the cost would be $510 for an MRI without contrast. At the time of the visit, however, when I tried to self-pay, I was told their “policy had changed” and I could not self pay because I had insurance. I should have cancelled and rescheduled the appointment somewhere else, but I went ahead with it and figured I could straighten out what I owed later. Ugh. Bad idea. I was billed $4700 for the visit (which for self-pay was $510) and after my ins. write off they are saying I owe $2500, 5 times the amount I had planned to pay.

    I have attempted to contact the Billing Dept in writing by mail and email 5 different times (and also including the CFO and Director of Billing Dept) since January (I received the bill in Dec) and to date have had NO response whatsoever from any of these attempts. I explained my situation in the letters, and that I am completely willing to pay the bill in an amount that I feel is fair and reasonable, and would like an appointment to discuss it and pay. No response. I contacted our State (GA) insurance commissioner’s office as well and they said I should have a right to self-pay. HIPAA laws (as printed on the hospital info) states that I have a right to “fair and reasonable” charges and I do not feel that being billed more than NINE times more than what I was ready to pay on the date of the visit is fair and reasonable.

    We have been paying $25/month towards the bill until we can get it resolved, and it looks like this month it was sent to Collections, still with no response to any of my inquiries.

    HELP? What should I do next? Leave it in Collections? Negotiate with Collections or continue to try with the hospital, and who?

    Thank you!

  18. Anonymous says:

    My wife gave birth to a perfectly normal baby girl through V.D. late last year. Our total bills added up to $9,733.09 among the hospital, anesthesiologist, gynecologist, pathologist and pediatrician, which we had to pay entirely out-of-pocket. The only reasonable bills were from the pathologist and pediatrician. I would imagine the actual total costs were around $1,000-$3,000. But paying $10,000 is really unbelievable. I feel it is unethical, disingenuous and fraudulent, yet, I feel helpless in fighting these bills despite multiple phone calls. One of the bills from the gynecologist’s office amounted to $3,317.18 under Code ‘59610’. I asked for an itemized list and was told that they could not itemize it. Unfortunately, I do not qualify for financial aid, but these bills are an enormous burden on my family. What are my options and how do I proceed to have the bills audited? I saw that I can file a complaint with the Agency for Healthcare Research and Quality. I am also writing letters to all parties.. Any help would be appreciated!

  19. wayne says:

    I feel that the Hospital For Special Surgery discriminates in terms of its pricing. My wife had a procedure done when we were insured with Oxford and they accepted the payment from Oxford as payment in full. We changed health insurance providers and she had a similar procedure done. They accepted the payment from the Ins company and are seeking the balance from me. There are no published rates for their services and I was not told in advance how much it would cost. They accepted the money from my insurance company and are now billing me $3849.41. The money they were paid satisfied the complete bill last time the procedure was done. If dry cleaners in NYC need to post minimum and maximum charges for a shirt or pair of pants why dont the hospitals have to?

    I tried to address this with HSS and got nowhere. They told me I could apply to their financial assistance program but my earnings are just outside their limit. Their pricing is discriminatory. I want my bill to be reduced to the rate that they accept from insurance carriers. I would also like to see some consumer protection put in place for their varied billing practices. They are billing usurious rates when someone does not have health insurance or has a plan they do not accept yet they accept significantly reduced payments from carriers they participate with. A dollar is a dollar and I should not be discriminated for having a different health plan and should be given the opportunity for service at a rate they charge other carriers.

  20. James says:

    I had to go to an emergency room in Panama City, FL. I was having very bad pain in my left. Told them I woke up in pain. The outside of my left arm had very little feeling in it. I would not have gone to the emergency room except that the pain was so bad that I could not sleep, eat or move the arm. After sitting from over two hours I was given a shot and a prescription and released. I was on vacation away from my home state. I am a Vietnam Veteran, I was refused service at the Bay area vet out patient center and forced to go to the emergency room. I received a bill in the mail today of $1,900.00 for a shot and prescription. I called and requested a itemized statement, and they refused. Where should I go from here.

  21. JT says:

    My daughter had surgery almost two years ago for some ovarian cysts. I signed her in for the surgery even though at that time I had no insurance. Her mother’s husband provides the insurance. We have always paid 50% of whatever the insurance doesn’t cover per our custody agreement. After the surgery, my daughter had to follow up with a Gynecologist in the same hospital. I have never taken her to see this doctor, although her mother has. When her mother takes her to see this doctor, I always get the bills in my name. I have called and spoken to the billing people at the hospital and they basically said that I am responsible for the bill for the surgery since I am the one who brought her, and to get her mother to pay her part I would need to take her mother back to court to enforce our custody agreement. And that’s fine. I paid my 50% of what was owed on the surgery. Since the hospital told me it just depends on who brings her in and signs to be responsible for the bill, shouldn’t they start sending the bills to her mother instead of me? Especially since the insurance is in my daughter’s Step Father’s name?

  22. Okan says:

    Hi,

    Back in June 2016 I went to see a foot specialist doctor for my sprained ankle. He prescribed me physical therapy and asked me to go see him again after. My ankle got better. The insurance paid for the physical therapy but kept denying the bill for the doctor visit saying it’s been billed with a code that says “flat foot” which I did not go to the doctor for. I had several calls wasting hour on the phone and every time I called been told that they will change the code and submit again. This has been happening maybe 8 times over the same $135 bill. And I just received the same bill yet again. Do I have to keep dealing with this? Or can I just ignore it. Please help, Thanks.

  23. Bharath says:

    Hi,
    I had visited a doctor’s office last year for yearly physical routine which is free and completely covered by my insurance. But the doctor’s office charged me around $132 for this visit. Doctor’s office never responded properly when I contacted them several times. Finally one day they suggested to contact Aetna insurance company. Aetna told that doctor’s office used wrong code and they need to send correct code. Again I had not got proper response. I started receiving calls from the collections. I paid the bill to avoid risk of getting poor credit rating.

    Can you please suggest how can I complain on them and get my money back.

  24. Jeff says:

    Hi,
    I fell off my motorcycle going ~30 mph. My friend took me into the ER. They rolled me into the treating room, gave me a tetnis shot , hooked me up to an IV, gave me a morphine dose, and took me to get a couple of cat scans. I was discharged after 5 hours. I was uninsured. The bill came out to be ~$36,000. They said they applied a non-insured discount, which brought it down to ~$25,000. I called and asked for an itemized bill statement, which they will send within 10 days. Is there anything else I can do? $25,000 does not sound reasonable, even for a few CAT scans.
    Thank you for your help.

  25. Kat says:

    Hi, My son had a visit with a specialist at Scott and White Clinic. We have Blue cross Blue Shield insurance and for specialist visit we suppose to pay a copay $30. Before the visit I made sure I was going to be responsible just for that amount. I asked them clearly if it is normal visit and my responsibility is a copay. They apparently billed my insurance for two things, office visit and outpatient office visit saying that I signed document stating that they bill every visit as outpatient. I got copies of that documents and the statements says “I voluntary request and consent to hospital care or outpatient treatment ordered by my healthcare professionals. This include but is not limited to diagnostic testing( such as labs and xrays), medical, nursing or surgical treatment or anesthesia services. This consent is continuing in nature unless specifically revoked by me.” I read it before I signed it and asked person at the front desk if it is normal office visit and I got confirmation from her. That does not clearly specify that every visit is treated as outpatient and I think writing that way and having not educated and well trained employees is a wrong doing. How can I get rid of outpatient charges on that visit. I feel like it is cheating and taking advantage of people so far big pharma and medical institution have freedom do whatever they want but customers don’t have freedom and right to know the costs upfront like in every European country. How can I approach it to make take this charges off my account?
    Thank you for your help
    Kat

  26. Becky says:

    My husband went to the doctor for an annual physical. While at the visit the doctor asked him about something he has mentioned was bothering him in a previous visit. My husband told him the issue was no longer bothering him. When we received the EOB from the insurance company he had billed for the “well visit” and was paid by the insurance company. He also billed the insurance company for a “sick visit” in the amount of $195. My husband has been trying to clear this up since October and the staff in the doctors office refuses to answer his questions or give an itemized statement. What should we do?

  27. Cleo says:

    I just received a bill from former OB Gyn from services rendered 8 years ago. When I called the office to speak with the person in charge of billing,my call was passed around and was finally referred to office manager. When I asked to explain the bill, I was told that the office didn’t have a dedicated person to follow up on patient’s accounts and when they came around to look for outdated accounts, statements were mailed out. I was also told that they have sent statements to me in 2009, 2013, 2016, which of course didn’t make sense since I would have disputed the bill on those dates. Bottom line is, I don’t have a way of validating the charges since it was made 8 years ago or even contact old insurance. I feel that there is some fraudulent billing activities going. What do you advise me to do?

  28. AnnaLiza says:

    I am distraught! I am currently undergoing treatment for a fibroid using Lupron shots once a month. These injections are provided and delivered by Perform Specialty Pharmacy, set up by the receptionist at my GYN’s office.

    Having been approved by insurance, I received my injection in December. However, I never received notification either by phone or traditional paper mail regarding an invoice related to the amount I owe for that dose. Because of this, I was unaware of my obligation to pay or when payment needed to be made.

    One month later, I thought I would be receiving my next dose at my next doctor’s visit for January. Imagine my embarrassment to be told I couldn’t receive it because they didn’t deliver it to the office because of an unpaid balance of which I wasn’t aware!

    The doctor was upset as these injections are time sensitive and needed to prevent my bleeding which at one point requires a blood transfusion! In a rush to get my January dose in time, I had to call the pharmacy and reluctantly paid over the phone using a credit card! Very unprofessional and unorthodox!

    However, as a result of rushed payment, they sent out the medication & I had to return two days later for another visit just to receive the dose!

    Afraid this would happen again, I called February 8th to act proactively to prevent this incident. They told me someone would contact me in a week…No body did! And then once again they repeated the fact that there was a previous balance unpaid. I told them it was paid and they needed to check again more carefully. It took four people to see that my payment was misplaced! The representative told me they would fix that!

    Two hours later that same day, they found that I did pay that amount! I verbalized my frustration about the lack of written statement provided in mail to alert my attention to the charge in question! Even their online welcome packet states that patients have the right to written information regarding any charges or changes made. I complained about their disorganization and the fact that I had to pay once again blindly over the phone on February 21st!

    At the end of that phone exchange, I admantly asked that a statement be sent to me. She sent an email with a file itemizing transaction for both 1/24 & the current paid balance for that day!

    Luckily I saved it because now as I anticipate a new injection scheduled for March 21st as well as surgery at end of month, this pharmacy is now claiming I still owe money for December’s dose, which was written as paid on the invoice provided in the email they sent me!

    Luckily my insurance covers nearly 50% of cost of a drug that is still considerable amount! My source of grief, stress, & anxiety is that this has been a constant pattern with them. I asked if I could simply receive a statement in which I could pay with full disclosure of amount? Luckily I have accessed my EOB from my insurance to assure the balance is not some exorbitant random number they fabricated.

    I have called the company two days in a row. The representatives have been courteous & patient. I just feel they are working under a very flawed system. This morning I spoke with one of the same people & they clarified everything finally after a week of anxious and emotional emails.

    As I wrote this message, they called said they cleared and confirmed the initial unpaid balance as being received. She added that she emailed me invoices & explanations as well as sent paper mail as per my insistence in previous emails. She said she will talk with her manager as to how this process could be run smoother.

    I posted this message in the hopes I wasn’t alone with such problems. In my anticipation for surgery in less than two weeks, this has just been an added inconvenience and stress. I took for granted my benefits until my health was starting to be seriously affected.

    Truly, one’s health is one’s wealth!

  29. Sandra says:

    I live in Michigan….I have been receiving bills from a medical supply company for medical supplies required for my husband. I have been very confused by their billing, but to make a long story short, I found out (after much digging and time lapse) that they went out of network and my insurance company of that time period did not want to pay once that occurred. I was never notified by the company that they were out of network…..does this fact have any impact on my billing? Thank you for any help in clearing up this confusing medical issue.

  30. Eve says:

    Our infertility clinic clearly states charges as well as insurance adjustments and payments on their statements, but our payments (all of which we have receipts for) are not credited for the full amount of the payment on or around the date we pay. Instead, for example, a payment of $160.00 may be credited in various amounts several weeks apart. Because of this practice, $115.00 of our payments “went missing.” Shouldn’t they credit our account with the full amount of the payment on or near the day we paid it?

  31. Sadiq says:

    My doctor charge double for the same office visit where can I complaint?

    • says:

      Hi, Sadiq. If you have contacted the billing department and have not have any success, try talking to the office manager. Do you have insurance? Was the insurance company billed twice? Contact the insurance company to let them know you have been billed twice. If you pay on your own and paid with a check or credit or debit card, there is a paper trail to use as proof that this office visit has already been paid for. If you need further help, feel free to call us at 855-203-7058.

  32. Rahul says:

    I was reading your article and want to discuss regarding overcharged billing done by one of the center for day surgery for just performing endoscopy. They charged my insurance for almost $7500 to perform the endoscopy and remaining deductible came to my pocket, which was $2500. At the time of asking the detailed itemized bill; they sent “Facility fees” as an entry and threaten me to go over to collection agencies etc. I am not sure how to move further. Please guide.

    • says:

      Hi, Rahul. Thanks for reaching out. Could you give us a call at 855-203-7058? We would like to get more details to assist.

  33. Mac says:

    Recently I’ve been to a dentist office for a procedure, I asked them to talk to my insurance and confirm my portion of the bill before going for procedure.
    They gave an estimate and I did the procedure, however later they gave a different bill because they didn’t give the right estimate from the insurance and the doctor’s office is asking me to pay extra money (around $300) just because they weren’t able to get the amount from my insurance (from what they estimated).

    What should I do in this scenario, it isn’t my mistake.

    • says:

      Hi, Mac. Could you give us a call so that we can get more information? 855-203-7058. Thanks!

  34. Timothy says:

    Hi,
    I live in Callifornia and recently took my adult son, age 21 to the emergency room. I signed no medical paperwork or financial agreement – though though my work provided insurance was used. The subsequent bill is in my name, not my son’s. Is this legal? Who has the legal responsiblity to pay? Me? Or my son?
    Thanks,
    Tim

    • says:

      Hi, Timothy. Thank you for reaching out! Can we get a few more details to assist? Our number is 855-203-7058.

  35. Jane says:

    I gave birth to my baby on feb. this year and I received a bill of $2944 out of pocket after all insurance payment. I called the hospital and they gave me a 5% off discount if I can pay immediately one time and they said after the payment the case will be closed. However, on may I received another bill for $2259 and they even add back the 5% discount money they gave me last time!! And they didn’t tell me where the $2259 came from just saying it’s “balance transfer”. What should I do.

    • says:

      Hi, Jane. Thanks for reaching out. We’ll be happy to try to assist, but we need some more information. Can you give us a call? Our Consumer line is 855-203-7058.

  36. Chris says:

    I seem to be having some problems with Henry ford medical/health system. The billing department doesent seem to be very interested in working with me as far as my bill pertains. They expect the balance paid off fully within 90 days and or 3 billing statements; it seems to be a forgien concept if someone is attempting to pay them to send them a bill each month until its paid off; nope they want you paid off in 3 months or they send your account to a collection agency.

    I got a bill from henry ford medical in the mail in march, I could not afford the full balance so each week, I sent them something one money order each week; I sent them a total of $42 in payments for march, they only credited me with one of 4 payments for $5 for the month of march, so I stopped sending payments. About 3 weeks ago I call to get on payment arrangements for a MRI I got a couple months a ago, I tell the call agent I’ll make $50 monthly payments, he gives me this song n dance that his computer program will only approve $60, I give in and agree. 2 weeks ago I call in the 1st payment. So last week I get a letter from some collection agency in Ohio saying I owe $500 for unpaid services to henry ford.

    Any advice or suggestions?

    • says:

      Hi, Chris. We hear about this type of scenario very often. Why don’t you call our Consumer Division at 855-203-7058 so that we can get some more information?

  37. Brenda says:

    I was referred to see another doctor and my referring doctor made the appt. I got paperwork and appt card in the mail. I realized I could not keep the appt as I am disabled and live out of town plus I have a sleep disorders and cant do early mornings. So I called and talked to Abby and she was helpful, got me a new appt and was to put me on a cancelation list to try and get in sooner. Then a few days before my original appt I get an auto call that I still had the original appt I canceled with Abby. So I called and was told Abby was gone until Tuesday and I had to talk to her. I said I want to make sure this appt is canceled , so lady said she would take my name and number and Abby will call me Tuesday. She nevre called and I forgot about it and then Wednesday I get another auto call that I missed my appt and to call to reschedule. I call and talk to Abby who says she never talked to me or made an appt!! What….I went over what we talked about but she still said no I document everything and I dont have anything. I said fine, I need an appt then. So I got another appt. I was not happy and really wasnt looking forward to going now if this is how they run their office. Then last week I get a bill from then for 50.00 for a no show fee! I called and asked to talk to billing and Abby said I can help you. I said we talked several times and I had canceled my original appt so why am I being chraged. She said I never called and she has no documents that I talked to her and thats their policy. I said I did talk to you before this first appt and also called when I got a auto message about appt and was told you would call me on Tuesday but you never did. So ho is it my fault that a mistake on your end is costing me 50.00? she said thats our policy. I said I am not paying this as I am disabled on SS and I cant afford that. Told her I would talk to the doctor. She said you do what you want and I will talk to the doctor also. Very cocky and rude. I called my referring doctors nurse to file complaint and office manager called and I said I do not feel comfortable going to this office if they cant get things right and want to change me for something I took care of. I said I still have the other appt we made but I am scared to call to cancel as I dont trust them to cancel my appt and try to charge me another 50.00. So manager said she would call to cancel appt and make note of this and who she talks to. Can you help me get this charge taken off? I feel it is fraudulent as I did call and cancel appt and then even called another time but they never called me back?

    • says:

      Hi, Brenda. Thanks for reaching out. This is a very unfortunate situation that we do hear from time to time. Unfortunately, if the original call was not documented, there is not much of a way of proving that it happened. But there are some other things that might help. First, is there a sign posted in the office area that talks about a fee for non-cancelled appointments? Or did you sign something acknowledging this? If not, this is something you can bring up. Also, you might want to escalate this to the office manager to see if there is anything that can be done. I hope this information helps!

  38. Stefanie says:

    Can i get billed legally by professional and facility for the same procedure on the same day? I got billed by the physician and the hospital for an ultrasound. I didn’t step foot in the hospital and I wasn’t notified of the way they bill like this. It seems unjust, he is affiliated but again I was not informed.

    • says:

      Hi, Stefanie. Thanks for reaching out. In some instances, you may receive a bill from both the facility and the physician. Can you give us a call so that we can get more details and try to assist? 855-203-7058.

  39. Luisa says:

    I have a question, is it legal from doctors to hide information about being approved by the insurance, nd then bill the patient for something they knew was not being paid due to the same. I went to a cardiologist in Jacksonville and I usually search the doctors name under my provider to make sure they are in network. Well, he’s name shows up and I made the appointment. I always asked before any test what was the copay, and their response was:”we don’t do any test unless the insurance approves it” 6 month after I received a bill for $1600, I called the insurance and they informed me that the doctors office was not yet approved with them, and any bills before the approval was not covered. So why this happened, why the doctor and the insurance did not communicate this, now I have this bill on my credit report and I don’t feel I have to pay it. Please help, I feel deceived by both the doctor and the insurance.

    • says:

      Hi, Luisa. Unfortunately, this situation is all too common and that is why we advocate that patients contact their insurance companies prior to any service or procedure to make sure that it is covered under their insurance policy — as well as the provider themselves. Did you happen to sign anything that states that they don’t perform tests and/or services without prior approval? Give us a call at 855-203-7058.

  40. Tricia says:

    Hi. I am having a huge problem getting a refund from a Dr. I saw the doctor in May and I paid cash for services. I asked for a paid bill so I can submit to my insurance company (I get a certain % back for out of network doctors after deductable is met). She refused and said she would send it b/c it was n’t ready. She proceeded to send my insurance company a bill as if I did not pay. The insurance company sent them money instead of sending it to me (b/c she filled it out as if I did not pay). I called dr office and office staff is giving me a run around for 2 months. Oh, we only do refunds at the end of the month…Oh, the July 4 holiday threw us off…I emailed the doctor to approve refund….oh, no one is here who can help you. Trying to get the money refunded to me has become a huge issue. Is there anything I can do?
    Tricia

    • says:

      Tricia, please know that you are not alone. We receives complaints such as this regularly. Can you give us a call so that we can try to assist? 855-203-7058

  41. Julie says:

    Last year, while on vacation out of state , my husband had a medical emergency that required ambulance transport to a nearby emergency room. My insurance was billed for everything (doctor, hospital, ambulance) and my insurance paid. The ambulance was out of network, so it was paid by my insurance company as out of network. I received a bill from the ambulance company after the insurance company paid. That bill showed two credits: one for the insurance company payment ($400) and one for the balance not covered by the insurance because the ambulance company was out of network ($400). The bill from the ambulance company very clearly stated I only owed $100 balance due (my co-pay). “At this time the balance is due.” I made a payment online the day I received the bill. Now, one year after receiving and paying that bill, the ambulance company has sent a new bill saying that I now owe the $400 not covered by the insurance. The new bill shows a new charge of $400 posted to my account earlier this year. They’ve given no explanation for the charge. Is this legal? What can I do to fight this? Had they charged me last year when they sent the original bill, I would have been willing to pay the $400. But I feel like this is a case of bait and switch, sending a bill with one balance then turning around and sending a new bill after the account was paid in full. What’s to keep them from coming back and trying to charge me again if I pay this? At the same time, we’ve worked hard to have a good credit rating. I hate to see a $400 charge ruin it. What can I do?