Adam Deutsch, Esq.

In this episode of the Financial Consumer Rights Talk, attorney Adam Deutsch tackles the topic of medical fraud and how some health care providers improperly bill patients or services that should be paid by the insurance company.

Adam Deutsch discusses a growing trend of medical fraud reported by clients of Denbeaux and Denbeaux. Apparently, physicians are overbilling patients for procedures. The way the fraud appears is first they charge the co-pay and they bill again for changes that should be paid the insurance company.

The excuse given by the health care provider is that the claim was submitted too late to be paid, or the insurance company has refused to pay the claim.

The patient has no obligation to pay for charges agreed to by the provider and the insurance company, and the provider cannot pass on that demand for payment for the services to the patient.

The impact of this practice is that medical billing departments wind up harassing patients for payment. The patient in tum contacts the insurance company to clear up the matter. Even after the insurance company corresponds with the patient that this is not an acceptable practice and the patient is not obligated to pay the extra charges, providers continue to demand payment.

The problem then escalates when the matter is turned over to a collection agency, who in turn hires an attorney to sue to collect a debt not owed to them.

When faced with this situation patients do have a recourse which is to sue the health care provider, the collection agency, and the law firm for damages which include counsel fees and court costs.

Consumers who are victim to this kind of behavior are encouraged to question the bill and fight back against the provider’s fraudulent billing practices. If consumers ignore the situation and don’t fight back things can go from bad to worse to an absolute nightmare.

If a Complaint filed by the law firm that is hired by the collection agency goes unanswered a default judgment can get filed which can result in garnishment of wages and/or a bank levy on the patient’s bank account.

Adam Deutsch recommends that patients shouldn’t wait until they are sued before raising questions about medical bills and suspected medical fraud. If they are sued should immediately seek advice from an attorney.