Hosptial and insurance company billing for services not performed
Port Angeles, WA
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Posted about 1 year ago in Insurance
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P99213 O/P visit:
The local hospital has bought an older Family practice building. The physicians were hired by the hospital as their employee's, meaning that all staff is supplied by the hospital. Now here's a concern of mine. I made an appointment to see my physician for a consult and discussion of medications. 30 days later I received two different EOB's from my insurance and a bill from the hospital showing P99213- $110.00 O/P Visit, established patient and a 99215- $172.80 O/P Visit, established patient. Both the hospital and the doctor were charging a fee for the same service. I never even went to the hospital nor had any type of procedure done at the hospital yet they charged me for a level 3 office visit. Fraud: somebody who deliberately deceives somebody else, usually for financial gain. The hospital billed the Insurance and then billed me the patient for services not rendered.
Additional information
My doctor billed the insurance company for services that were not rendered to me. She billed the insurance company for an office visit and I never went to her office. So now I have to pay my portion of a bill for services I never got. What can happen to the doctor if I notify my insurance company about this? Answers (2)J. Brantley Durrett III
This attorney is licensed in Texas.
Posted about 1 year ago.
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Simply show the hospital the EOBs and ask for an explanation and an appropriate refund. Also write a letter to your carrier alerting them to the problem and their failure to identify it in their review..Hospital billing is notoriously inaccurate. When my daughter was born, the hospital billed me for a circumcision!! Talk about medical malpractice....
Steven Wayne Murray
This attorney is licensed in California.
Posted about 1 year ago.
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It appears you did not get billed for the same services since the two codes are different. It may be that the total billing was split into two separate bills, one from each. Find out from the hospital what the description of code 99213 is and also what code 99214 is. Then you will understand the nature of each of the bills, and if there is a duplication, you will know how to go about resolving it.
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