Insurance fraud

Anonymous Poster · Mar 28, 2003

When I was a teenager I lied one time about my age to get in the races close to where I live and save about 75 cents. Well I opened my mouth later on at home and said something about it in front of my dear dad,man I got a lecture (rear end chewing) I still remember. He never knew realized what a favor he done for me by making me realize what I had done was not cute or funny but WRONG. I have seen guys I work with sneak a pipefitting/some small item out of the plant you could get at the hardware store for $2.00 and risk a $60,000 a year job for stupidity. Go figure....

Wood_Butcher_Dav · Mar 28, 2003

I can relate because they charged me (Insurance) $54 for a reusable ice pack. The therapy session was $72. I still had to pay 10%. /forums/images/graemlins/frown.gif

Dave

Wingnut · Mar 28, 2003

my first experience with US medical billing practices shocked me greatly ... never been in the hospital (other than working in one in my younger days as a medic) but my previous wife spent a great deal of time in-and-out before she died.
Anyway ... to cut to the chase ... I was a little surpised when the anaesthesiologist showed up early the next morning to ask how I was ... took a look at the drain in my leg and said something ot the effect that there seemed to be no discharge and he'd just get rid of it for me. I was a little surprised because I don't consider the gas guys as having any duties after the operation .... but I soon found out what that was all about. There was a $700+ change on the bill fo rthat service.
In all, having a nail pulled from my leg with a pair of vice grips and staying overnight in the hospital "for observation" resulted in a bill for $4300 and my share was about $1000.
With my experience in Canada ... you can imagine my shock and anger. The hospital billing departments response "standard practice", "standard billing" (standard billing included a $5 charge for a box of tissues I never even opened ... wonder how many times they "sold" that box.
They chase ordinary folks for insurance fraud ... when the hospitals have perfected that game to the nth degree!

pete

Taylortractornut · Mar 28, 2003

April 23rd will be the 2 year aniversary of my bad crash took the fire dept. 50 minutes to get me cut out, mom's a nurse and she got to the scene and climbed in the back door to support my back while the VFD worked on getting me out. I was a half mile from the hospital and the ambualnce got there. but the plan was to airlift me at the scene. when they got me out i put in the ambulance for 2 minutes till the helicopter got settled to keep me from gettin dusty. The bill for that was 780 dollars for an ambulance ride. 7000 for the 50 mile flight ididnt complain about that or anesthesiaology's fee. But physical thereapy where thy picked me up and made me walk a few stepes 2 times a day was 1200 a session. I only had 4 days till company insurance covered me si there i was no insurance, just started out from hard times then they hit me with 43 000 dollar bill. THey took half of it off for a taxes, bt then i got the Surgeons Association for 5000 dollars for folks that never even saw me, My surgeon also got 2000, and i had to got to his office 60 miles away once a week for 2 months to get an Xray and some advice at 800 a visit I quit a few of them and my dad was having surgery so i took his place running a dozer and scraper at a wood landfill. Till i was released to got back to work at Huffman. my friend Denise is 28 and has a pacemaker and her's was supposed to last i think 20 years and she got sick well turned uot the surgeon used the wrong thing and it caused a prematur failure they billed her 18 000 for a nw one she talked with a lawyer and they ended up dropping the cost because of the mistake.

thcri · Mar 28, 2003

Our insurance company has asked up to looked at all of our bills and watch for fraud. If we find fraud they will re-imburse us for it. Kind of neat. You find they bill you for something you didn't get and you get a reward for it.

murph

jhburke · Mar 28, 2003

Your experience is exactly why when I am in the hospital and I see anything in supplies used. I tell them I want whatever balance of anything that they used. IE such things as box of rubber gloves, cordage in short anything I can carry out. If I get any questions I tell them to sign a statement that it wasn't used. Naturaly they won't do it. If I am going to pay for it I want it. I had them use aboutl 6' foot of cord off a 50' roll and when they started to leave with the unused roll I made them leave it because I knew I was going to be billed for the whole roll. /forums/images/graemlins/grin.gif

bgott · Mar 29, 2003

I do that most of the time. Today I went to Cummins to pick up some filters and the guy undercharged me by a filter. I told him about it and it kind of befuddled him, I guess he'd never had anyone tell him before. He gave me a nifty cap for telling him. /forums/images/graemlins/smile.gif I won't say a thing at Home Depot, though. That company has absolutely no respect for their customers. I have wasted so much time in their stores looking for help or standing in a check out line that I figure that I'm owed way more than I can ever let them screw themselves out of. Situational ethics, I guess.

jhburke · Mar 29, 2003

I had just got out of the army. I was working as a insurance salesman. I had to go to the bank to get some big bills changed for smaller. As I had just gotten out of a situation of having to stand in line for everything and wasn't to happy to be doing it again. When the teller gave me my change I stepped to the side to count it and not hold up the others behind me. She had given me 10.00 to much. As I was still standing just to one side of her cage, I waited until she finished with her customer. I said mam you and before I could say anything else she said you have left the window there is nothing I can do. I tryed 2 times more to explain. When she kept repeating her first statement. I just told her thanks for the extra 10.00 and left. I will try to correct mistakes but I won't fight to do it.

Bird · Mar 29, 2003

Murph, I never heard of an insurance company doing that, but sounds like a good idea, except for one thing. Seems to me that nearly every bill sent out would qualify. I just today got a bill from my wife's oncologist. It was for one 15 minute office visit and a blood sample was drawn for a blood test. With an itemized bill showing seventeen separate charges, he billed the insurance company for $1,454.00. Since he's one of their PPO members, the insurance company's "contractual adjustment" lowered that to $637.23 and then paid 80% of that. Now some of the things on that itemized bill I don't understand, so I can't say whether they're right or not, but we told the doctor that she is taking B12 injections once a month (another doctor had written the prescription and I administer the injections at a cost - with no help from insurance - of less than $2 per injection). Well, his itemized bill included $72.00 for B12 - the contractual adjustment lowered that to $6.00, but of course he did not provide any B12 at all. /forums/images/graemlins/shocked.gif

I also had to go to a new doctor this week, a gastroenterologist, who is also one of the insurance company's PPO members. This one wanted his 20% (my part) up front, so I paid $41.00 (20%) for a 10 minute office visit. I hate to think what he's going to charge next week for the colonoscopy. /forums/images/graemlins/frown.gif And he also decided he wants to run a tube down my throat to check from that direction, too. I told my wife I hope if he uses the same tube, he does the top part first. /forums/images/graemlins/crazy.gif

In my opinion, this country is in desparate need of a complete overhaul of the health care system to include doctors, hospitals, and insurance companies.

thcri · Mar 29, 2003

Bird,

We don't get the full amount but only a percentage of the amount we find. In fact it is a nice deal but for you to sit down and go through the whole bill and try and remember what you didn't get is kind of tough. But it does keep the clinics and doctors somewhat honest because they know your insurance will catch them on things.

murph