DrugBuyers.Com: Taste of "Humble Pie"

A similar situation here. I was the billing manager for a board and care facility for the semi-functional mentally ill. Almost without exception, the patients were receiving either Medicare or Medical Assistance. Because the government medical programs reimburse at a flat rate, they wanted the charges doctored to "make up" the difference. There were other billing discrepancies, too. Knowing this was illegal as well as immoral, and that the officials would come knocking on my door if things came to a head (the way it was structured was that I got a "bonus" for collecting based on a tier percentage) I quickly moved on. In my own defense, I didn't realize what was going on until I had developed an understanding of the process about 6 months into my tenure there. I left immediately.

Another point, always check over your hospital bills/statements---even if your insurance covers everything. After my c-section some years ago, I was putting things in my daughter's baby book and because she was 8 weeks premature, I had several hospital bills I put in it (to prove she really was a $100,000 baby)...I noticed that MY portion of the bill had dozens of drug charges on it. During my 4 day stay in the hospital, I received 1 morphine injection, morphine spinal anesthesia, 6 injections of demerol, and a percocet and motrin every 3 hours for 3 days. That was it. I was charged for something like 20 demerol injections (almost no hospital will give injectable meds for post-op pain for longer than a day or two, tops), lots of Halcion (as if a nursing mother would take this!), lots of Ativan, Darvocet, even a few Dilaudid injections. I called the hospital billing department and explained that if I had taken ALL of those medications as an inpatient for FOUR days, I wouldn't have even been able to get out of bed! They did reverse the charges and credited my insurance company after an "investigation"...then I learned sometime later (from my insurance company) that an "employee" had been diverting drugs from that hospital in that ward. She probably had gotten away with it for a long time, too. The way they appeared on my bill was in their generic name forms--someone without medication knowledge would probably have assumed it was the name of the meds they received.

Hopefully this was just an isolated incident, but I warn everyone to always ask the nurse what meds they are given, in what strengths and CHECK YOUR BILLS!

--------------------
Never underestimate the predictability of stupidity.