Hi all, here’s the story and grievance letter I sent. Wondering if others have had similar experiences.
10/13/2022- I had fallen on my elbow and was in a lot of pain. I decided to go home and try to sleep it off. I did not want to go to the ER because I wanted to avoid the sheer cost of it. 10/14/2022- I wake up with having pain still in my elbow. I decide to go to urgent care. An X-ray was taken of my elbow and I purchased a sling this day. I was billed $480 discounted to $382.77. This was for a new doctor (382.77) and the sling was covered by insurance. Claim #XXXXXXXXX. This is all correct so far. I was also billed an additional $320 discounted to $124.57 for the evaluation of the X-ray. This is also correct. Claim #XXXXXXXX. That is all fair play and correct. Shortly after the urgent care visit I was reccomened to follow up with an orthopedic specialist. I had no initial plans of doing this, but I did anyways. Before I scheduled this I had called and EXPLICITLY asked how much this was going to cost me. I was told around $400. Similar to the new doctor fee as mentioned above ($382.77) Knowing this information I decided to schedule the appointment. 10/20/2022- I go into the appointment. I spend about 15 minutes or so with (DOCTOR NAME). The extent of the service had been: 1. I take off the sling 2. I was asked to move my elbow around to show range of motion 3. DOCTOR diagnosis was to remove the sling and make sure to move my elbow around so it doesn't get sore. I was billed for "Immobilize a broken elbow: Closed Rx Radial Head/Neck Fx - 24650 (CPT®) DOCTOR did not provide me with the services described under 24650. The total bill for my 10/20 visit was $2550 discounted to $1,439.11. I was in the office for less than a half hour and am getting billed thousands of dollars for an appointment that I didn't even want to go to. I believe this is fraud and the hospital is upcoding. I filed a review with the hospital and of course their own internal audit said they did not do anything wrong.
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