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Zeke Zeke is online now
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Join Date: Jan 2002
Location: Long Beach CA, the sewer by the sea.
Posts: 38,252
I think I'm about to uncover some medical billing fraud.

I had the usual blood work done in May. All seems well. That is until I get a bill from the lab. $768.75. BC paid $141, the charges were *adjusted* down 66 and a mysterious 'other' adjustment (upcharge) was added. I end up owing 600.

BC denied most of the work done except for some very basic tests like PSA and full count. All work related to thyroid and other organs is denied payment. I've seen this movie before.

What has happened in the past is that a code for a chest x-ray was changed from one indicating that I had some symptoms to one that reflected something like I walked in one day and said, "Let's do an x-ray for no particular reason." That resulted in my owing about 500 dollars. 4 months of calling the doc's office that ordered the x-ray and the billing company and with a letter from the doc got it resolved. I paid nothing just as my plan indicates.

So, what's going on? Well, obviously the labs stand to make a LOT more money it they can NOT get paid by insurance and bill direct. I've asked for all the paperwork from the doc and the billing so I get all the codes.

When I compare them to last year's billing and get some facts, I think I will find out what's up. Attempting to nick me for the full monte using code manipulation. In one call just asking for this information they *offered" me a 'discount' of $240 if I pay now.

Oh, and it's the same folks who did the x-ray scam on me. I think once I get all the paper work this is one for an investigative news reporter to dig up some info.
Old 07-06-2013, 09:57 AM
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