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What kind of an Attorney would handle medical up bill charges?

  1. Ron Tulotta profile image54
    Ron Tulottaposted 6 years ago

    What kind of an Attorney would handle medical up bill charges?

    So I was told by my insurance compNy to go to the local authorities and contact a an Attorney to work on getting me money that my Doctor caused me to lose. Because he was "up" billing me and saying I had a chronic asthma issue and was being treated for it (all a lie, he even charged me for visits I was never at) I lostoit on my medical discount at my job for last year and now this year.
    I am going to the local DA's office today to file a complaint of fraud and was also told my my very large insurance company to seek an Attorney. What kind of an Attorney would I use and how would I find one?

  2. SmartAndFun profile image96
    SmartAndFunposted 6 years ago

    I am not an attorney so I may be giving terrible advice, but I would wait and see what the DA says, as they may be able to help you if you are the victim of a white-collar crime. Also file a complaint with the medical board that oversees the doctor, and also get their opinion on the next step to take. I would think that the the insurance company also has a staff of attorneys that would look into it on the inusrance company's behalf (?). As far as what type of attorney, I'm thinking a medical malpractice attorney. Hopefully someone more knowledgable will chime in with more accurate advice.

  3. Ron Tulotta profile image54
    Ron Tulottaposted 6 years ago

    How do i find out what medical board by doctor belongs to?

  4. Jillian Barclay profile image80
    Jillian Barclayposted 6 years ago

    First, each state has a board that handles complaints about doctors. They can usually be found under consumer protection listings in your state. Most of the time, a complaint can be filed online.

    Second, to privately sue a physician for something like this, you would want to find an attorney who specializes in consumer fraud, because even as a patient, you are a consumer who is buying his services. Have a feeling the doctor may be defrauding more than just you and your insurance company, most likely Medicare and Medicaid, too. Call your County or State Bar Association. They may be able to refer you. If this were Medicare or Medicaid, I would suggest that you find an attorney who specializes in what is called "qui tam". When a private citizen helps to prosecute Medicare or Medicaid fraud by a doctor, the law of "qui tam" allows that citizen to receive part of the recovery. Perhaps,  if you find a qui tam attorney in your area, he or she could refer you to an equally knwledgable attorney who handles commercial insurance fraud.

    Thank you for being so brave, because most people who experience this keep their mouths shut. Every once in awhile, I come across someone who says, "No way! This is wrong and I am not going to let you do this anymore, to me or anyone else!"

    Upbilling or upcoding is fraud. It is illegal in every state in this country and on the federal level. As for charging for visits that you never had, that is the epitomy of theft.