I just received a text and a billing statement for healthcare services. The services were rendered almost a year ago. I paid in full shortly after the visit as soon as the full balance was known (insurance had only paid a small part of the cost). The bill is clearly a mistake: it doesn’t show the amount I paid though I have documentation that I paid it and a previous statement that shows it was received and left a zero balance.

A few months ago, I got a notice that my credit card was being directly billed for an amount I owed from a healthcare appointment more than a year prior. I never authorized billing to my credit card and I absolutely did not owe any money.

It had happened several more times before that, and I’m a reasonably healthy individual. The first time I noticed it was when I spent some time in the ICU (nothing serious, but a weird, long story) and over a year afterwards I got bills from three of the hospital’s contracted providers for their services. I had high-end insurance that was supposed to cover everything. So I called the insurance company, and they sent me documentation that all the charges they were trying to collect had been fully paid many months earlier.

it’s a scam, a fraud, a grift, a swindle — NOT a mistake

In every one of these cases, when I’ve gathered my evidence then called to dispute the charges, they have immediately said (without apology!) oh, it’s a mistake, we’ll delete the charges.

“Once is happenstance. Twice is coincidence. Three times is enemy action” - Ian Fleming

It has now happened to me at least ten times.

I’m a retired physician. I keep very good records. I’m young and healthy enough to be on top of this game. I review my medical bills with a knowledgeable and focused eye. What about someone who is sick or elderly or overwhelmed by medical jargon? These vulnerable people simply get ripped off, that’s what. I don’t know whether the billing company keeps all the ill-gotten gain, or if they split it with the medical practice. I don’t care: it’s theft by deception, and has no place in health care.

Is it just incredibly sloppy billing practice? No, or it doesn’t matter.

what can be done about it?

Complaining to the billing companies doesn’t help: they’ve got a nice little racket going, and they’re not going to stop just because someone who isn’t even their customer whines about it.

Complaining to the doctor’s office doesn’t seem to help. They have other things to do and as long as their billing company is (1) bringing in the revenue and (b) not giving them too much trouble, they’ll be more than willing to write off the occasional patient complaint with “mistakes will happen.” The complaints will remain occasional because of the remarkable way billing companies make bills overly complicated and difficult to understand.

is it fair to report it as fraud?

Not only is it fair (what isn’t fair is allowing medical practices and their hired goons to continue to rip off the sick, the vulnerable, and the confused who trust them with their care), we all have a duty to help stop this horror.

Complain to your insurance company. I have Medicare, which is even better as they have a fraud hotline. Do it first, before you call the medical practice or billing company. Only if a medical practice knows they might become the target of a fraud investigation (without an opportunity to blow the whole thing off as a “billing mistake”) will they lean on their billing companies to be honest in the first place. Only then will they stop swindling their vulnerable patients.


PS. Before somebody writes to say “you just don’t understand how complicated medical office billing is!”, I should mentioned that I owned and operated a medical practice for over ten years.

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