insurance fraud or what?

[SANDWICHED]

What is the name of your state? South Carolina

i was in an accident and have med-pay on my auto insurance, health ins., plus the other at-fault party ins claim # to file bills and wages when i go back to work... well the question i have is that a certain ortho spec that ive seen twice has billed all 3 companies on each visit for the same amounts, also taking money from me--20% of the bill((my part after my health ins.)), the billing advocate had me sign 2 papers after they took my health ins. card and asked for all claim #'s (to my med pay and the at-faults ins. company), now ive found out that my health ins company (they barter the amount down) has paid these bills and i owe 60.00 for both visits (she didn't include the amounts I've paid out of pocket during processing to my health ins.) and she has faxed the other 2 companies bills for 275.00 and 254.00 (each one for the 2 separate visits and for those checks to be made payable to them) my husband called today to ask about the amounts she'd faxed and she said that what i signed was a lien on the amount that i owe them and that it would be paid directly to them. he asked why did she file the full amounts to the other insuarce companies before she found out what the health ins was going to pay, like i thought you are suppose to do ''legally''. then she said that if they all mail her checks, the amount that exceeds the bill will be reimbursed to my health ins..????? i don't know what to think of this and what to do?? Is this not insurance fraud?? and if it is what do I need to do??? she will receive over 1300.00 if she triples up on the insurance policies. I was so out of it from the meds and pain at the time she had me giving her info and signing stuff, I don't know how someone could take such awful advantage of someone.

 

[seniorjudge]

What is the name of your state? South Carolina

i was in an accident and have med-pay on my auto insurance, health ins., plus the other at-fault party ins claim # to file bills and wages when i go back to work... well the question i have is that a certain ortho spec that ive seen twice has billed all 3 companies on each visit for the same amounts, also taking money from me--20% of the bill((my part after my health ins.)), the billing advocate had me sign 2 papers after they took my health ins. card and asked for all claim #'s (to my med pay and the at-faults ins. company), now ive found out that my health ins company (they barter the amount down) has paid these bills and i owe 60.00 for both visits (she didn't include the amounts I've paid out of pocket during processing to my health ins.) and she has faxed the other 2 companies bills for 275.00 and 254.00 (each one for the 2 separate visits and for those checks to be made payable to them) my husband called today to ask about the amounts she'd faxed and she said that what i signed was a lien on the amount that i owe them and that it would be paid directly to them. he asked why did she file the full amounts to the other insuarce companies before she found out what the health ins was going to pay, like i thought you are suppose to do ''legally''. then she said that if they all mail her checks, the amount that exceeds the bill will be reimbursed to my health ins..????? i don't know what to think of this and what to do?? Is this not insurance fraud?? and if it is what do I need to do??? she will receive over 1300.00 if she triples up on the insurance policies. I was so out of it from the meds and pain at the time she had me giving her info and signing stuff, I don't know how someone could take such awful advantage of someone.

What did your insurance carrier say when you told them this?

 

[SANDWICHED]

they said she faxed them lein papers with my signature on them to make any amounts from that ortho spec to be mailed and made out to them. My med-pay and the other (at faults) said they have to pay whatever amount she faxes to them. I got a copy of one of my EOB's from my health ins. provider today and was planning on faxing it to each company. It states that I only owe 29.00 (which I paid before I left the office that day.) I should receive the second one shortly (EOB). I guess this is all I can do.

 

[seniorjudge]

they said she faxed them lein papers with my signature on them to make any amounts from that ortho spec to be mailed and made out to them. My med-pay and the other (at faults) said they have to pay whatever amount she faxes to them. I got a copy of one of my EOB's from my health ins. provider today and was planning on faxing it to each company. It states that I only owe 29.00 (which I paid before I left the office that day.) I should receive the second one shortly (EOB). I guess this is all I can do.

So you're saying the insurance carrier doesn't care if it's being defrauded?

 

[SANDWICHED]

my med-pay adjuster isn't the brightest star in the sky, and for all I know has already issused payment (can barely reach him, tried to call today), the at-fault's adjuster says she can't do anything till I go back to work before she can make a call on the settlement of this case. My husband said that the advocate was real nasty to my husband and told him she knows what she is doing and that it is legal.>?? She (the billing advocate) claims she hasn't received payment from anyone, but I check online from my health insurance and it states otherwise. Plus I wrote checks for my part of the 20%. So actually they've been paid in full, so why is she submitting bills to the other companies? Can she legally triple the amounts that she collects? I'm suppose to follow up with this doctor later this month, should I try to go over her head on this one. And those papers I signed, I had no idea they were lein papers, she wouldn't let my husband back there when she was talking to me, she said I couldn't see the doctor until I took care of that process (and they already had scanned my health insurance card??) I'm pretty sure I'm not the only one she's scammed before.