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Mc_Big_G

The real scam perpetrated by hospitals and doctor's offices is rebilling.

It works like this:

1) They send a bill with no information about the services performed.

2a) You waste your time tracking down what it was and then pay it.

2b) You pay the bill without wasting your time to verify.

3) They wait somewhere between a month and 6 months.

4) After receiving payment, they bill you again for the same services.

5a) You waste your time tracking down the services and the fact that you already paid. Then you waste more time calling and forcing them to stop billing you. You get an "Oops, sorry! I can't imagine how that happened."

5b) You pay the bill without wasting your time to verify.

Repeat steps 3 through 5 until they've sucked as much time and money out of you as possible.

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Yes. There is extensive intentional fraud and corruption in the system, along with rampant profiteering that exists regardless of whether an entity has been granted "non-profit" status. (Non-profit doesn't mean you can't pay everyone on the board of directions millions in compensation.)

Each time I've dealt with it (mostly helping relatives with their confusing bills) there's been double and triple billing, and billing for procedures not performed, and for work done by people that weren't present, or on days the patient wasn't even present. The more complex the treatment, the more entities jump in to the feeding trough for a share. You have to keep extensive records of everything actually done, which is not always possible if you are not with the patient 24/7. Then when the bills come they are full of hundreds of cryptic codes. You might have some procedure done that takes 30 minutes, and get 20 different bills from 10 different entities, sent over a period of 18 months following the procedure, which apparently now lasted days and involved dozens of people, medicines, tools, and tests, some done multiple times.

The primary reason medicine costs crazy amounts in the US is because of corruption and fraud. Sending a lot of these people to prison could do a lot to reduce costs and straighten things out. That and single payer.

You don’t even need there to be conscious corruption. If the system churns out incorrect bills through simple error (perhaps because the hospital never bothered to drag its accounting system out of the 1970s), and an overcharge is just as likely to be paid as a correct bill¹, then the bad system will stay in place without anyone twirling his mustache and sneering about his obscene profits.

¹Which is to say: Consumers in bad financial situations will dispute or default on overcharges, but they’ll do the same for correct bills. Insurance companies will occasionally dispute an overcharge, leading to six months of paperwork back and forth until they agree on what to pay, but they’ll put correct bills through the same wringer.

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