No. of Recommendations: 1
- Once the bill is submitted through insurance, it is insurance fraud if you do not charge the patient the amount the insurance company says is the patient's part. (This is usually part of the language of the insurance providers' agreements with the practices.) If they want to write off a bill, they have to write off the *whole* bill, not just what insurance doesn't pay.

Coming from a medical family, I'm not sure this completey reflects reality. Sure, the patient has to be charged their agreed amount, co-pay or whatever, but let's say you have a $20 co-pay on a $200 service. A bill for $180 gets sent to the insurance company. They pay whatever they feel like based on their own rate tables and the doctor is left with the excess. That's how it works. The patient is paying their agreed part, the insurance pays what they feel like, and the doctor is stuck with not getting the rest.

And if the doctor increases their rates on some procedure, it can be years until the insurance company compensates any more. It's not that the patient isn't paying their agreed part, it's that the insurance company isn't paying the rest of it, because they never agreed to anything with the doctor... and there's really about nothing a doctor can do about it. Yeah, they swallow the change instead of charging it to the patient to maintain good relations.

Another reason the doctor's 'rates' are so high, because they rarely collect more than some of it.
Print the post  


UGC Disclosure Notice Regarding Credit Card Posts
Community board discussions about credit cards are not provided or commissioned by banks who may have advertising relationships with The Motley Fool. Responses have not been reviewed, approved or otherwise endorsed by the bank advertiser. It is not the bank advertiser's responsibility to ensure all posts and/or questions are answered.
TMF Credit Center
The Motley Fool Credit Center arms you with real tools and simple messages, that will help you in every credit situation.
When Life Gives You Lemons
We all have had hardships and made poor decisions. The important thing is how we respond and grow. Read the story of a Fool who started from nothing, and looks to gain everything.
Contact Us
Contact Customer Service and other Fool departments here.
Work for Fools?
Winner of the Washingtonian great places to work, and Glassdoor #1 Company to Work For 2015! Have access to all of TMF's online and email products for FREE, and be paid for your contributions to TMF! Click the link and start your Fool career.