re: What in the hell is wrong with medical billing?

quote:

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Insurance has no control over how a medical facility bills

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Well yeah. But they certainly do control decisions of payment based on what they consider medically necessary per their medical guidelines. In some cases the insurance company may be in the right, in other cases they may not be. Even if a service is pre authorized, they may decide not to pay.

Obviously these situations leave patients in a bind when hospitals and providers attempt to collect on services rendered but denied by the patients insurance.