Need help with hospital fraud
By coffeebreak
@coffeebreak (17798)
United States
January 25, 2010 11:23am CST
Does anyone know of where I can turn in a hospital for price gouging and charging me for things that I did not ask for, did not know they were doing, and did not give my permission for them to do? They drugged me into oblivion and did things that were so unrelated to the reason I was there (a CAT scan of my head cause I was in for food poisoning for example) and now are charging me for these things.
Any comments, suggestions or contact would be VERY appreciated. And also if you know of a place, lawyer or such that can help me fight these charges.. that'd be VERY appreciated too! Thanks in advance to all!
1 person likes this
4 responses
@LaurenInLA (2270)
• United States
25 Jan 10
Do you have medical insurance? If so, the place to start is to file a grievance with your insurance company. I live in California and when a grievance is filed, a copy of it is sent to the State Insurance Commissioner. If you do not have insurance, I would file a complaint with your State Insurance Commissioner. Be aware though that it is not typical for a hospital to ask for permission on every procedure that they perform if you've signed the inital paperwork giving them permission to treat you. In terms of the CAT scan, they may have tried to rule out a neurological disorder that was causing your symptoms. In terms of suing etc, try legal aid or your state bar association for a recommendation. Consultations are free but you may have a hard time finding someone to take this case. It is going to be very difficult to prove that you didn't need these procedures. You might also want to check with your State Insurance Commissioner to see if there have been complaints filed against this hospital for the same kinds of things that you experienced.
1 person likes this
@coffeebreak (17798)
• United States
29 Jan 10
No insurance. Thought I had it, but of course, when I got home and checked on it... it didn't get approved as apparently Blue Cross can over ride a doctors orders and if they don't think you need a medication, then they won't cover you cause your doctor prescribed it for you.
@LaurenInLA (2270)
• United States
29 Jan 10
Call your insurance company and file a grievance now. Let me share my story with you. On 1/28/09, DH had a stroke and hit his head on the sidewalk, causing a traumatic brain injury. He was alone at the time. Paramedics were called and he was rushed to a county trauma center. I found out where he was the following day and when I went to the hospital, I was told that he was the sickest man in the hospital and needed immediate brain surgery to remove the clot. The last thing on my mind at the time was contacting Blue Cross to see if he was in an in network hospital. He wasn't stable enough to be moved until 2/12. Blue Cross told me that they would only pay 50% of the acceptable charges, leaving us with an exposure of over $300,000. I learned that I could file a grievance and that Blue Cross would respond within 30 days. I filed the grievance and I won. Blue Cross paid the entire medical bill. There is a grievance process in terms of medication etc. I encourage you to pursue this avenue. Almost a year later, Blue Cross tried to charge back the payments that they already made for the ambulance that took him to the hospital and the ambulance that took him to an in network hospital. Again, I filed a grievance and won. Insurance companies will say no every chance that they get. Most people don't go to the time and trouble to go through the process but I would certainly pursue this avenue before I sought an attorney. It's going to be very difficult to prove that the medical professionals were not acting in your best interest.
@macdingolinger (10386)
• United States
25 Jan 10
My guess is to contact a lawyer. You might also look in the informational pages of a phone book to see if there is a number to call. I know the lawyers can be reported to a bar association. There must be someone to report hospitals and doctors to!
@coffeebreak (17798)
• United States
29 Jan 10
Well thanks for that! Appreciate your thoughts! I hate hospitals for this exact reason. Only have been 3 times in my life... twice with pregnancy and once with a brain tumor. THey were at least intelligent, real and workable times. THis time... nothing but being scammed for money as so many illegals get free medical attention, that they jack up the prices on the rest of us to cover their butts budget.
@Hatley (163781)
• Garden Grove, California
26 Jan 10
coffeebreak are you so conversant of all medical procedures that you know they did not know what they were doing, a lot of non medical people get their tail feathers in a know over some procedures that really are necessary to find out just what is wrong with an ill person. Doctors are not gods, they cannot just wave a wand and it will magically tell them you have this or that wrong with you.Cat scans are done for a number of reasons, and while you might think it had nothing to do with food poisoning you might have been having some symptoms that made them think that there might be something more wrong than just simple food poisoning. You may not know this but a lot of medical procedures your consent is not needed as they are standard for whatever illness they think you may have. You went there because you were ill and now are complaining that they tried to find out for sure what caused your illness? If you know so much more about medicine than the doctors or nurses then why did you go there in the first place?Did you check to see at other hospitals what the ordinary going price was for the things you are complaining about.?for price gouging you need to go to your insurance and start from there. I really wonder how you could think that they did not know what they were doing? you were a layperson or are you in the medical field? I have little sympathy for laypeople who come to the hospital to get well,then are helped back to good health, yet complain about the way they did it. to begin with you should have health insurance that would take care of almost all those charges.
