What would you like to do?

Is it Medicare fraud for a company to bill commercial insurance companies a higher fee-for-service than they are billing Medicare for the same service?

already exists.

Would you like to merge this question into it?

already exists as an alternate of this question.

Would you like to make it the primary and merge this question into it?

exists and is an alternate of .


Insurance companies negotiate rates for services at the best advantage to them. Companies with larger groups get the best rates becaues they have more economic leverage. Medicare is the 900 pound gorilla in the insurance world. So the short answer is no, it is not fraudulent. The reason is each insurance company will pay at their own negotiated rate regardless of how much the provider charges.
196 people found this useful
Thanks for the feedback!

Doctor issued prescription for Mothers wheelchair. Ordered from company who now claims they do not deal with Medicare insurance. Mother billed entire cost on her CC. What recourse can be used now?

  First, never order anything without checking whether or not a medical supplier works with Medicare. There are numerous suppliers who do work with Medicare and sell wheel

Can a Medicare provider bill a secondary insurance for the Medicare deductible?

  This is directly from the Medicare and You 2009 Book:   When you have other insurance, there are rules that decide whether Medicare or your other insurance pays first

Can they rebill medicare again if I received a bill from the hospital almost 2 years after spouses death because insurance company made a mistake am I responsible because medicare should pay rest?

Medicare would have covered all the remainder if my insurance had not made the error "Can they rebill medicare again I received a bill from the hospital almost 2 years after s

Is it Medicare fraud for a company to bill medicare more than others for the same service?

No.   What many people do not understand is that providers DO NOT  determine their own reimbursement rate. When providers decide to  join a network, for example Aetna, t

Is there a deadline for billing an insured for services denied by an insurance company?

Yes. If the medical provider wants to challenge the denial then the medical provider must submit his request for reconsideration within a certain time limit. The bill-er would
In Uncategorized

What do billing services companies do?

Different companies have different regulations. For example, credit card companies each offer similar products but the different between them comes in the structure of interes

Is billing for a service not performed considered insurance fraud?

Obviously, it's a fraud because a contract of insurance is acontract uf Utmost good faith technically known as uberrimafides.So, billing for a service not performed is a breac