South Bay surgery clinics overbilled, insurance giant claims
By tovarichpeter Follow Sat, 2 Jun 2012, 8:44pm 327 views 1 comment
In South San Francisco CA 94080
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This violates anti-kickback laws - physicians can't refer only to clinics in which they hold an interest. Patients had to have been promised that they wouldn't pay out-of-pocket, which also violates their contract with their insurer.
The overbilling is crazy - when you go out-of-network they do bill for full charges and the patient is usually left holding the bag. In this case, Aetna paid and that's funny as hell. I'm sure that the clinics added all sorts of charges, it's the 'merican way.
They'll win their lawsuit, though. The MD's should have to present proof that they offered the patient options within their network and the patients refused. They won't even get a spanking, though.