[ComfortablyNumb5]

I was just talking to someone about my
past jobs because I came across an article on the local news about a OBGYN billing Medicare fraudulently and funneling prescription meds to dealers. Well I'm in the medical field and I'd have to say, that doesn't surprise me, about the insurance fraud at least. Every doctor I have worked for has billed for higher services that they did not give. When I left one of my jobs, I found out the manager (and office biller)scammed and milked almost 4 million out of insurance with fake procedures that never took place. Everything between a $5 urine and up.

What is everyone's else's experience or knowledge as far as where you've worked or know about (whether you're an employee or patient)? Maybe it differs from state to state, country to country (im sure), or office to office. But unfortunately I've experienced it many times. And im sure we've experienced it just being patients too. But this is a thing that really concerns me and I think people need to be looking at this a lot more. This hurts everyone in the business. Even I as a patient have gotten bills for procedures I've never had and had to argue it out with insurance and doctors. So I see it from my work life as well as personal.

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[Jan1212]

In my place the doc or nurses dont deal with the insurance. There's another special.office for.it . As a patient I have gotten tests and the codes don't mean anything to me. I had BCBS of a certain state and had to fight everytime. We need a change in Healthcare real bad. Real bad.

please DO NOT quote ANY SELECTION of my post. thank you. have a good day.

[Mrs. Mania]

I once got charged for a office apt to a Dr. I didn't even know. Through research, I found that he assisted during my c-section AND was paid! I called the office to say I didn't even know where they were located and surely hadn't been there. The receptionist was extremely rude insisting that I came for an appointment! So, I wrote them a letter which was answered by a threat of collections. I reported them to the BBB and got a swift apology and the bill was history. What a load.

My sister use to do billing for Blue Cross Blue Shield. They brought in a manager from NC to VT and they used certain billing codes to double bill and falsify billings to insurances. My sister quit over it and finally retired. She got tired of all the false illegalities going on. Myself i went to a University health clinic doctor. They billed me for 95% of the bill and made me pay for it. I got a statement from Medicare and they paid the bill so i reported the drs, office and hospital. I got a refund cheque for over $100.00. I have since gotten rid of that dr. and moved to a different hospital and doctors entirely.
It is everywhere and now people stop going to doctors, they force you to see them every 3 months to get your medicines resubscribed. It is all a scam and people only put up with doctors cause you need a pcp for medicare and prescrips. Totally disgusted the greed has got to end somewhere... tc

[fishin fool]

We need universal health care once and for all.
The present system is a huge scam and most people
are getting awful health care and still getting stuck with
co-pays that they can't afford.

[Calico_91]

That's one reason why I didn't become a medical biller/coder. There's just way too much risk. How do I know whether a medical record is true or not? Sometimes the coders get their butts reamed by law enforcement right along with the doctors because the doctors point the finger at the coders and the coders usually don't have the money for the defense attorneys the doctors have.