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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73 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?

    • Christie Hudson says:

      Thank you for your question! You should request a detailed, itemized statement from Henry Ford Health Systems and United Health. Also request a bank statement for these time periods. Verify whether or not payments were made and when and if there are any discrepancies, send a certified letter to the CFO of the facility and request that corrections be made within ten business days. If this does not resolve the issue, I would send all of this information to my state’s attorney general and ask for their assistance. I hope this helps!

  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!

    • Pat Palmer Pat Palmer says:

      I would certainly be concerned about charges I had been billed by both providers. In order for a provider to bill you for any charges, they must have detailed documentation of services provided to receive reimbursement. First, order a detailed, itemized statement from the providers, as well as the documentation to support the charges. We would love to help you. Please feel free to contact us again if you need any more 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?

    • Pat Palmer Pat Palmer says:

      Thanks so much for reaching out about this matter! First, request a detailed, itemized statement of every charge you are being billed for that visit and any adjustments, credits received, and payments from insurance companies. Let them know that until you receive these documents and are able to review these, the bill is to be considered in dispute and is on hold. Having these documents should help you better analyze what you actually owe. When you begin to see the charges and areas on the bill that are not correct, you can notify us and our consumer analysts can assist in getting this corrected for you.

  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:

    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


    • Pat Palmer Pat Palmer says:


      Unfortunately, we see this scenario on a regular basis with out-of-network surgeons and anesthesiologists. I would look to see what the balance billing laws are in your state, because that’s what this out-of-network doctor is trying to do. If balance billing is not legal in your state, notify the state’s attorney of your situation.
      Based on the information given, I would also suggest looking into small claims court, which should be fairly inexpensive. You may want to address another letter about having the above allowed amount adjusted off. If he refuses, since he doesn’t participate, let him know that you will take action to have the insurance retract the money they have paid to him and that you will deal with him directly on issuing him his payment. Let him know also that unless he can produce a signed document showing that you engaged his services and that you knew he was out-of-network, that you are not responsible for paying him anything. If you need our assistance with this, give us a call at 855-203-7058.

  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

    • Pat Palmer Pat Palmer says:

      I’m so sorry to hear about all of the trouble you are going through. Hopefully, I can point you in the right direction. Based on the information you have given, I would suggest that you ask the doctor for the documentation that they have in the system regarding what you were told in the beginning about being in-network, if you do not have anything in writing. There has to be documentation somewhere from the call they had with your health insurance to verify and for prior approval. Ask for these notes from the insurance company, as well.
      In light of mentioning the possibility of incorrect codes, I would recommend that you request a detailed, itemized statement of all charges and that you review each line item for non-compliant charges. If you need assistance with this, give us a call, and we can help.
      I would also suggest one additional attempt with the doctor. I suggest sending a certified letter consisting of the first conversation you had with the staff regarding your financial responsibility. Let him know in the letter that you have witnesses of that. In the letter, I suggest that you summarize the charges, and the payments from the insurance company, and anything that the insurance company says regarding your financial responsibility. Make the doctor an offer of the exact amount that you are told from the insurance company that would be your responsibility, and include any payments already made. If you can do so, let him know that this amount can be paid within 10 business days of receiving notification that this would be accepted. If, after 10 business days, you have not received a response from the doctor, I would let him know that you intend to contact the Office of Inspector General, the State Insurance Commissioner, CMS Fraud Unit and State Attorney General demanding a full investigation into their billing practices.
      Let us know if you need any additional help!

  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.

    • Pat Palmer Pat Palmer says:

      I’m so sorry for the situation you are both going through. Try sending a letter as a formal letter of dispute to the billing supervisor and copy the doctor on it. Request full adjustment on the tests that were not performed. Let them know that you expect a new bill showing full adjustment unless they can send medical records proving these tests were actually performed. If this matter is not resolved, you should consider involving a third party for a full investigation on their billing practices. Please don’t hesitate to give us a call if you need any further help with this matter.

  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?

    • Pat Palmer Pat Palmer says:

      I would recommend getting a detailed, itemized statement from January 1, 2015 to the present and make sure they understand that you want a breakdown of charges and payments applied to your account. This will show the payments and what charges they were applied to and where the balance is coming from.

  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!?!

    • Pat Palmer Pat Palmer says:

      What are the laws regarding the statute of limitations for collecting on medical bills in your state? Usually, the statutes of limitations range from 3-7 years, but this varies from state to state. Please give us a call so we can get more information on this and help you sort this out. 855-203-7058

  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

    • Pat Palmer Pat Palmer says:

      Request a detailed itemized statement of the charges and verify that all the services were performed. Ask the hospital if they offer any self-pay discounts or any type of financial assistance.

  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?

    • Pat Palmer Pat Palmer says:

      You are right; this is very unfortunate. I suggest that you return the bill along with a letter of dispute stating you canceled the appointment. Please contact MBAA’s sister company to help with any instance such as this in the future, should you need help. Medical Recovery Services can be reached at (855) 203-7058.

  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.

    • Pat Palmer Pat Palmer says:

      Contact the provider again and ask to speak to a supervisor. State that you have left messages to try to resolve a dispute that have not been returned. Send a letter of dispute to the supervisor and ask that this be placed on hold until resolved. Ask the insurance to provide you with a copy of the letter sent to the provider to attach to your dispute.

  13. Sanjay says:

    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.

    • Pat Palmer Pat Palmer says:

      You can still request a detailed, itemized statement of your medical bills. Request these from the facility and look for double billing. Contact the billing office and let them know of the errors and demand an updated, corrected bill be sent to you. Don’t be afraid to talk to the manager/supervisor to make this happen. Make sure that all of your payments are applied to the new bill. Please contact us if you need any help. 855-203-7058

  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.

    • Pat Palmer Pat Palmer says:

      Based on the information given, I suggest that you request the EOB from your health insurance company that shows the corrected amounts on it. According to what you have stated above, the EOB should state that you owe zero. Contact a supervisor at the hospital and send them this EOB directly and request a refund. If you had the service prior authorized, then they are obligated to only bill you what the insurance company has listed on the EOB. If you are unwilling, then I would suggest that you contact your insurance company and ask them to retract the payment made in error.

  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:


    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!

    • Pat Palmer Pat Palmer says:

      This type of behavior from medical facilities, unfortunately, is becoming very common. Please give us a call so that we can get more details and can help you get this bill lowered to what you actually owe. 855-203-7058

  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!

    • Pat Palmer Pat Palmer says:

      A lot of facilities will tell the patient that they cannot give you an itemized bill for a myriad of reasons, but everyone is entitled to a detailed, itemized statement of all charges. Otherwise, we are paying blindly, not knowing for what we are actually paying. If you would like us to assist, please give us a call at 855-203-7058 so that we can get more details and assist.

  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.

    • Pat Palmer Pat Palmer says:

      Wayne, I’m so sorry that you and your wife are experiencing this. We would like to get more information to be able to assist. Can you call our Consumer Division at 855-203-7058?

  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.

    • Pat Palmer Pat Palmer says:

      Hi James,

      I’m so sorry to hear that you are having this kind of trouble. I would like to try to get more details about why you were refused at the Bay Area Vet Outpatient Center. Without knowing more information, and certainly without the detailed, itemized statement, it’s difficult to ascertain the fairness and reasonableness of this pricing. Would you mind giving our Consumer Division a call at 855-203-7058?

      I can say that when you request a detailed, itemized statement of your bill, the facility is required to provide this to you. Otherwise, they are asking you to pay blindly for charges that are unknown to you. If you need help getting your itemized statement, we can certainly help you with that as well.

      And James, thank you so much for your service! We look forward to speaking with you soon.

  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?

    • Pat Palmer Pat Palmer says:

      Hi, JT. Unfortunately, whatever name is on the paperwork for financial responsibility is the person who the facility will bill. However, in some instances, the billing department might allow you to add another person, but that person would have to fill out the appropriate forms. Please don’t hesitate to give us a call if you need help with these bills. 855-203-7058.

  22. Okan says:


    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.

    • Pat Palmer Pat Palmer says:

      Hi, Okan. Unfortunately, ignoring this bill won’t make it go away and could cause problems down the road. Without having more details, it sounds like the provider might have used the wrong code and this will need to be changed to be corrected. Give us a call at 855-203-7058 so that we can get a little more information and try to assist.

  23. Bharath says:

    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.

    • Pat Palmer Pat Palmer says:

      This is a very common situation that we see with patients. Based on the information you have given, it appears that this needs to be resubmitted with the correct code. Could you give us a call so that we can discuss in more detail? 855-203-7058.

  24. Jeff says:

    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.

    • Pat Palmer Pat Palmer says:

      Hi, Jeff. You did the right thing by asking for the itemized statement. When you get the statement, review it for anything that looks unusual. Is there anything on it that you don’t remember receiving? Are you billed more than once for anything? Also look at the Level for which you were billed. There are varying levels of severity in the ER, and the higher the level, the more expensive it can be. If this was not a life-threatening condition, yet you were billed for a Level 5 ER visit, that should be questioned. Ask the billing department about any charges that you don’t agree with and if you still feel that you were billed improperly for something yet you can’t get satisfaction from the billing department, give us a call. Call us if you have any questions or if you would like us to help. 855-203-7058.

  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

  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?

    • Pat Palmer Pat Palmer says:

      Hi Becky,
      There are some new guidelines under ICD-10 that are helpful in this scenario. The following is a quote from the American Academy of Professional Coders. “ICD-10-CM strictly limits the circumstances under which a provider may report a same-day preventive visit and sick visit for the same patient. If the patient is symptomatic on arrival for a preventive visit, per ICD-10-CM guidelines, the visit no longer qualifies as a preventive encounter. A sick visit may be billed, but the preventive visit should be rescheduled.”
      I hope this information helps. Please don’t hesitate to give us a call at 855-203-7058.

  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?

    • Pat Palmer Pat Palmer says:

      Hi Cleo,
      Thank you for reaching out to MBAA. We will need to know what state you live in to properly assist. We will be sending an email to the email address you have listed. Thanks!

  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.

    • Pat Palmer Pat Palmer says:

      Hi, Sandra. Thank you for reaching out to Medical Billing Advocates of America. We would need more information to be able to help. Could you give us a call at 855-203-7058? Thanks!

  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?

    • Pat Palmer Pat Palmer says:

      Eve, gather your receipts and show your payments to the manager of the billing department. If your payments are not adjusted on your account according to the amounts that you have paid, escalate this to the facility CFO. If you need assistance, please don’t hesitate to give us a call at 855-203-7058.

  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.

  34. Timothy says:

    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?

  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. 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.

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