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?

Get Legal Help Today

 Secured with SHA-256 Encryption

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 7 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.


IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

Get Legal Help Today

Find the right lawyer for your legal issue.

 Secured with SHA-256 Encryption