Medical Billing Complaints

Written By :

Share This

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.

Filed under: Resources

Tagged with:

Pat Palmer
Written By :

The MBAA team is dedicated to providing quality education for public and professional use, as well as top notch corporate training. If you would like to speak about a medical bill audit, we can help with that as well. Please fill out the form...

Related Medical Bill Help

12 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!

Leave a Reply

*/ ?>