What can I do if I work for a doctor who gives discounts to his patients with insurance but then files for the full amount to the insurance companies?
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What can I do if I work for a doctor who gives discounts to his patients with insurance but then files for the full amount to the insurance companies?
I have told him it is considered fraud with the insurance companies he still does it. Wfat should my course of action be. I really need this job and know if I refuse to file it he will fire me.
Asked on July 17, 2014 under Insurance Law, North Carolina
Answers:
M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney
Answered 10 years ago | Contributor
I am not sure that I understand what you mean. When you say that he gives "discounts" do you mean that he alters his fees or alters the co-pay? A provider can collect or waive a co-pay. That is his choice. And when he files for the insurance he is paid the "usual and customary fee" as provided by the carrier as part of the plan so there is not really any "discount" he can give there. I am not really sure that there is fraud here. But if I have mis understood perhaps you should file an anonymous question with your state insurance department and ask. Good luck.
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