Is it theoretically possible for a doctor or staff to go and add a line item on a hospital bill for a test procedure that was never done on a patient? We live in a world with EMR's. What prevents a medical institution to create an exagerated bill other than a vulnerable patient to go line by line and decifer its contents? The insurance company is paying the big portion but some still trickles down to the patient. Just curious how vulnerable we are. Thank you.
Medical billing. Quality assurance.
Yes there are many doctors that will do this. Some doctors will add a test that is related to the reason why you went and add it on. The insurance wont see a red flag because it can be a common test or a normal exam related to the code they entered as to why you asked for an appointment. When you receive your bill look up the codes to verify you received the right services, if you don’t want to search call your insurance company directly and they will tell you what exactly you are being charged for. As someone who works in a medical office I can tell you there are doctors like that and some who wouldn’t even dream of doing this to patients. Those who are in charge of billing are ethically bound to tell our doctors we cannot over bill a patient but there are times where they cannot do that or report the doctor for doing this because it will cost them their job. Also, they take the risk that if you find out your over billed, the only person responsible for the mistake is the girls doing billing. The doctor can clean their hands and throw their employee under the bus, because the biller is responsible for everything reported to insurance.
Yes there are many doctors that will do this. Some doctors will add a test that is related to the reason why you went and add it on. The insurance wont see a red flag because it can be a common test or a normal exam related to the code they entered as to why you asked for an appointment. When you receive your bill look up the codes to verify you received the right services, if you don’t want to search call your insurance company directly and they will tell you what exactly you are being charged for. As someone who works in a medical office I can tell you there are doctors like that and some who wouldn’t even dream of doing this to patients. Those who are in charge of billing are ethically bound to tell our doctors we cannot over bill a patient but there are times where they cannot do that or report the doctor for doing this because it will cost them their job. Also, they take the risk that if you find out your over billed, the only person responsible for the mistake is the girls doing billing. The doctor can clean their hands and throw their employee under the bus, because the biller is responsible for everything reported to insurance.