Medical Billing Advocate May Be Able to Assist Consumers with Overcharges

Consumers may be entitled to compensation through a medical billing advocate if they received unfair California medical bills.

New reports suggest that California medical bills may include unfair or overcharged services for certain insured consumers. California medical providers may be overcharging patients for services such as lab work, urinalysis, blood work, MRIs, CT scans, genetic prenatal testing, infusions, and more. Consumers affected by unfair medical billing and overcharges may be able to contact a medical billing advocate to see if they are eligible for compensation.

In some cases, consumers insured with “PPO” insurance plans are paying extremely high co-pays. PPO insurance plans, or “preferred provider organization” plans, are the most popular type of insurance plans. These plans have “in-network” providers which are covered by the insurance at a higher rate than not in-network providers. PPO plans often have a yearly deductible, which is the minimum amount to be paid out of pocket before insurance will begin to cover services or cover services at a higher rate. However, consumers with these plans have reported paying overcharges on services and medicines.

There are several examples of unfair California medical bills and the problem affects both medical services and prescription drugs.

One example is PPO consumers paying a co-pay which exceeds the market value of the generic prescription drug they are purchasing. If a consumer pays a $20 co-pay on a generic prescription which is sold to uninsured patients for $1.75, they may be victim to unfair medical billing practices.

Similarly, other consumers have reported experiencing excessive drug markups. Pharmacists report that consumers across the nation are being charged excessive prices for medications when insured patients can fill them for significantly less. One pharmacist reports that PPO consumers pay $270 for a nausea drug that the pharmacy sells for $15 to consumers without insurance.

Another example of unfair medical billing practices is overcharging for medical procedures. Consumer report that labs charge insured patients much higher than uninsured patients for services such as biopsies, urinalysis, blood work, genetic prenatal testing, and other lab work. A lab may charge a PPO insured consumer $700 for a biopsy of a mole, when they charge $40 to an uninsured patient for the same service. Many PPO consumers have high deductibles which require them to pay the full amount out of pocket if the deductible hasn’t been met. This can cause serious financial strain on consumers.

Consumers may be eligible to speak with a medical billing advocate and seek compensation if they meet the following criteria:

• Live in California
• Have a preferred provider organization (PPO) health insurance plan
• Had an overcharge occur within the last three years
• Experienced an overcharge for a procedure AND/OR Paid a high co-pay on a generic prescription drug

Overcharges can cause serious financial damage to consumers, especially those with high deductibles. A medical billing advocate may be able to assist consumers in recovering compensation for overcharges, other financial damages, and possible punitive damages.

Join a Free Unfair Medical Billing Class Action Lawsuit Investigation

If you have a PPO insurance plan in California and have (i) paid a co-pay for generic prescription drugs at Rite Aid, or another retail pharmacy; or (ii) paid a higher-than-expected deductible for a covered medical procedure, you may be qualified to participate in this class action investigation.

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