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.