Let me describe the situation the other person is talking about, with two examples that happened to me in the past year.
1. I scheduled a colonoscopy with a hospital. They charged me $300 for the procedure, which I paid up front. Everything went smoothly and there were no delays, complications, or followups. A week later they sent me a bill for over $1k. They had not applied my $300 payment towards the total. They had not waited for insurance to reimburse them. They simply decided they could arbitrarily charge me more, and they did. Fortunately, my wife is somewhat familiar with medical billing and we did not pay. Insurance reimbursed them, then we called them and told them to apply the $300 we had already paid, at which point we owed nothing. If we had paid the $1k+ bill, I am sure we would not have been reimbursed.
2. I went to a clinic for a minor sports injury. They charged me a $60 consultation fee which I paid up front; I then spoke to the doctor for 15 minutes and got a prescription. A week later, I got a bill demanding an additional $180, and in that bill they claimed they had already been paid by my insurance. I checked with my insurance provider and found they had not even filed the claim yet. I ignored the bill, insurance reimbursed them, and they have not contacted me since.
Your characterization is ignorant of how scummy medical billing actually is.
> Your characterization is ignorant of how scummy medical billing actually is.
Concur completely. I once lived in a state where "Balance billing" was illegal, yet despite having a bluechip insurance plan, seeing some physicians in-network AND paying the co-pay at the same time, I could always count on being balance billed.
GRRRR. Talk about a seriously ticked off customer. Given what I know about medical billing though, I would not be surprised to hear that insurance companies were likewise trying to bilk the practices, forcing these shady responses (My wife's practice has an in-network private practice model, but insurers refuse to accept the billing rates they agreed to as a part of contract with the practice, and they play an intentional game of denials after previous authorizations, or, they intentionally send patients checks which the PTs go and cash, and fail to reimburse the practice)
FWIW for #1 if you had paid the fraudulent $1k bill, after your "insurance" paid you could have likely spent more time on the phone with the provider and gotten them to refund you. Of course if you had paid the fraudulent bill promptly they might not have even bothered billing your "insurance", meaning even more time/rounds on the phone in order to get them to do that.
1. I scheduled a colonoscopy with a hospital. They charged me $300 for the procedure, which I paid up front. Everything went smoothly and there were no delays, complications, or followups. A week later they sent me a bill for over $1k. They had not applied my $300 payment towards the total. They had not waited for insurance to reimburse them. They simply decided they could arbitrarily charge me more, and they did. Fortunately, my wife is somewhat familiar with medical billing and we did not pay. Insurance reimbursed them, then we called them and told them to apply the $300 we had already paid, at which point we owed nothing. If we had paid the $1k+ bill, I am sure we would not have been reimbursed.
2. I went to a clinic for a minor sports injury. They charged me a $60 consultation fee which I paid up front; I then spoke to the doctor for 15 minutes and got a prescription. A week later, I got a bill demanding an additional $180, and in that bill they claimed they had already been paid by my insurance. I checked with my insurance provider and found they had not even filed the claim yet. I ignored the bill, insurance reimbursed them, and they have not contacted me since.
Your characterization is ignorant of how scummy medical billing actually is.