My husband went to this facility for a screening procedure. I also had the same screening procedure at a different facility. The bill for my husband was $2,000 more than my procedure; $600 of that bill was considered our reasonability. When I called the customer service and spoke to R.R. and asked him how two screening procedures could have such differences in cost he explained that while Multicare tries to stay competitive, they cost more than other medical healthcare facilities. R.R. said they would do an audit.
I contacted Blue Cross fraud department. They discovered that Multicare had falsely billed it as a medical procedure, not a screening procedure. A call to my husband’s physician verified that this procedure was ordered as a screening, not medical procedure. The bill was adjusted. A couple of weeks later I received another bill from Multicare for $600as well as their audit. Their response is as follows;
The audit found that all items were billed correctly for the account were billed correctly and have supporting documentation in the Medical Record. Health systems set their own unique prices for procedures, which would explain the difference between the other facility. Therefore, no changes will be made to this account.
I again contacted R.R. in customer service. He stated the bill was sent out before blue Cross findings. When I expressed concern regarding his investigative audit and it’s lack of correctness he stated it was upper management that conducted the audit .