I let them know ONCE and then let them do it anyway and then report them for insurance fraud :)
I havent had to pay for a single one of those tests. I also do not communicate to the medical facility that I am reporting them for insurance fraud. I let my insurance company know that they have done a test they knew they shouldn't do and I also report them to the proper local authority.
I’m curious, does anything ever come of that? Do you hear back about how it’s handled?
This is tangentially how I got a tubal ligation and how I advise others who have struggled to access the same surgery. I called about a dozen doctors and told them what I was looking for. Gave them my demographics. Explained I’d been turned down before after attending initial appointments/exams due to info I’d provided upfront (like my age). Asked that they verify that the doc was willing to perform the surgery with that provided info, because if I was turned down I would report it to the insurance company as fraudulent. Made sure to be super polite while explaining. It took a bunch of calls but I finally found one and got my surgery.
Ironically, getting a hysterectomy was much easier though I chalk that up to getting a genuinely good doctor.
I dont often hear back from the authorities or the insurance company, but I check my online itemized bill with some regularity and I notice that charges suddenly disappear from it. I also do sometimes call my insurance company directly for an update if I am particularly ticked off or if it seems to take too long.
At the point that I am satisfied (fraudulent things removed), the bill is paid. Ive only had a bill go to collections once and I asked the collections agent if they knew that the bill was part of a fraud investigation and havent heard a peep since.
I dont blame you for using the same method, threats of reporting for fraud are surprisingly effective. They do not have a high tolerance for being investigated, especially because it can open them up to having other records looked into.
Because it might mislead someone into signing up until the misguided belief that they will be the exception too, when the far more likely outcome is that they will be as royally screwed over as the vast majority of UHC customers.
Doctors will straight up put procedures in their notes that never occured, you get charged, and the doctor makes more money. I'm currently in the middle of fighting upcoding in the hospital that I work at because we keep getting complaints of people being charged for things that never happened.
Due to having a special account to pay for medical care from, I document in detail all payments towards medical care.
I paid, lets say, $1,400 for account at hospital over this year. I got a bill saying that I still owed them $700 and had already paid $700. And the running total of the page documented $1,000 owed.
I called, pissed, rattled off all the info from the receipts I retained and asked them to justify the additional expense. They tried to say "oh its from stuff from before" but they couldn't be specific, and the transaction history did not display that (the transaction history showed 3 different procedures/visits, that had a total of $1,000 in cost). They could not explain why they did not retain the $1,400 or who had it, or why they would be "from another department" (and why that would use the same account number, if different bills/accounts/departments). I told them, listen, y'all, if I took you to court with the bill you sent me and all the receipts, you'd be ordered to refund me that $400 difference. So lets skip it and you send me a check already. They said they'd send me an itemized bill.
That was over a month ago. Silence since then. I've got a lawyer because I recently had to sue an ex-employer, I think I'll throw her $100 to send them a threat over the $400. If they don't pay, I will take them to small claims court for $500 ($400 for bill overpayment, +$100 for legal expenses+filing fees)
Honestly the only way they’ll ever change is if enough people fight back. Most people don’t want to deal with the hassle or be perceived as a “Karen” type. My wife and I routinely go to one another appointments to advocate for one another and it’s drastically improved our outcomes.
While being a polite Karen (insisting, forcing my way up the chain of command, getting shit done when noone wanted me to succeed), a state representative once called me "a significant disruption." while they were being forced to fire 3 prominent public-facing employees over time fraud, documentation fraud regarding who physically had an at-risk nonverbal special needs child in state custody, and racism respectively. Gave me such a rush I almost got it tattood on my chest. It was my job to advocate for the mom of that special needs child at the time. :)
And yes my wife and I go to eachothers appointments. Thankfully we found a doctor who doesn't try to mess with us now.
I still daydream about that tattoo but I'm too worried about autoimmune reactions and pain/fear of needles lol (I hate someone else needling me, I can stick myself for medication and IVs).
I have MCAS, so as soon as I heard that tattoo ink can travel into the lymphatic system I got concerned.
I'm thinking about doing something little as a test spot first. Ya know like a little brown freckle-sized heart on my ankle or wrist, or something pretty inconspicuous.
I finally have a good doctor and I will sing his praises till the day I die. It's amazing because after the upfront investment of going through my history with me, he rarely needs to see me for more than a few minutes because we have great communication and he has fixed many of my issues. Being a good doctor took effort in the short term but has rewarded him with free time in the long term, as well as a very compliant patient who will be fully honest and who refers literally everyone to him.
My first few visits with my good doctor were quite long, because I had a huge gap in my medical history due to doctors refusing to send me to the correct specialist, so I stopped bothering, because they'd be like "I can't help with that but you're not unwell enough to see a specialist, lose weight fatty."
I got to see the specialists I needed, and I'm losing weight thanks to hormone correction (I literally could not lose weight before, I'm eating more than ever but still losing weight now that the hormones are being managed).
One of my favorite books, Snow Crash, (which yes, is rather pulpy but-in a self-aware way, it's great) contains the following passage:
This is the guy. Raven. This is the guy that Juanita is looking for. The guy Lagos told him not to mess with. And Hiro has seen him before, outside the entrance to The Black Sun. This is the guy who gave the Snow Crash card to Da5id.
The tattoo on his forehead consists of three words, written in block letters: POOR IMPULSE CONTROL.
Hiro startles and actually jumps into the air as Vitaly Chernobyl and the Meltdowns launch into their opening number, "Radiation Burn." It is a tornado of mostly high-pitched noise and distortion, like being flung bodily through a wall of fishhooks.
These days, most states are franchulates or Burbclaves, much too small to have anything like a jail, or even a judicial system. So when someone does something bad, they try to find quick and dirty punishments, like flogging, confiscation of property, public humiliation, or, in the case of people who have a high potential of going onto hurt others, a warning tattoo on a prominent body part.
POOR IMPULSE CONTROL
Apparently, this guy went to such a place and lost his temper real bad.
And your anecdote made me imagine you with a similar tattoo, but worn as a badge of honor.
The most charitable take would still be 'anti-hero', at best. There's some defensible motivations behind a lot of their actions, but they're overall pretty rotten, sorry to say. It's a foundational work in the cyberpunk genre if that's something you're into, though.
I’m curious, does anything ever come of that? Do you hear back about how it’s handled?
Health insurance companies take FWA (fraud, waste, and abuse) VERY seriously. Think of all the posts on reddit about denied claims/authorizations...you think they want to pay healthcare providers for fraudulent services?
This is why i specifically notify my insurance company, rather than the facility. They clean things up the fastest. They basically foam at the mouth when it is a repeat offender.
SO - doctors actually are totally legally within their rights to deny elective surgeries due to their own personal feelings about it. It's not insurance fraud. The other major hurdle with sterilization surgery is even if you find a doctor that's game, there are lots of hospitals (usually religiously affiliated ones with "saint" in the name) that have their own restrictions on sterilization happening at the hospital that overrules even an agreeing doc.
I had a tubal done too, and I found my amazing doc via the r/childfree subreddit where users have compiled a list of doctors and leave reviews. Was able to save myself a lot of legwork and find someone relatively quickly thanks to that sub for my own tubal!
It’s not fraud for a doctor to turn you down for a surgery for a legitimate reason. Like doing the pre-op testing and finding that you’re anemic would be reasonable.
However, if you call an office and provide your age and number of children up front only to attend an appointment and be declined due to your age and/or number of children, that’s 100% fraud. If they have a criteria you must meet to be eligible and know you are not but book your appointment anyways, they’re doing so for the sole purpose of taking you or your insurances money. I’ve absolutely reported offices for doing this and gone through the investigation process and gotten my bills dismissed.
Unfortunately it just doesn't work in my experience.
I got blacklisted from the OBGYN network in my area for insisting on the procedure I wanted despite her opinion that I would want children in the future. I let her know I would be getting the procedure done whether she approved or not because I'm sure what I want done with my own body. She didn't like it and now I am not able to seek care at all in my area. :)
Yes, I did end up driving a couple hours to a Planned Parenthood and getting something else done there for now (due to funding, some of their services have been cut). Thank fuck for PP.
I have a similar issue, im intersex and things are a little funky in the reproductive department, had an obgyn tell me im young and to take Tylenol after she ordered an internal ultrasound, didnt specify to me that I would be getting penatrated for this test, then pressured me into it.
I got super lucky and was able to find a doctor who wasnt connected to her practice who would at the very least sterilize me to lessen the risk.
Probably. But one must have money to play games in the courts, and if we had capital we wouldn't be here on Reddit complaining about access to adequate care.
People have said that that, but I'm not really sure? The reason I'm blacklisted from the whole network is because she works at all of the locations. or... she owns them all? or something? It was hard to find the office she was at on my appointment day because of all the different addresses. I think it's legally within her rights to refuse care to someone? I've got no idea and I've got no money for a lawsuit anyway.
I misread and thought that said "I want 30 crows to like you" and was like, ...I actually like that compliment. I was about to give you commendations until I read it again, and then collapsed the thread and realized it was a username reference.
How much do they usually charge for a pregnancy test? I seem to remember hearing that most care facilities will use the same pregnancy tests sold in dollar stores, so I doubt it's really costing them anything to not get reimbursed.
The irony is it's probably your insurance providers own policy that they run a pregnancy test no matter what. Anything to deny/obstruct treatment as much as possible. Reporting it as fraud just makes them eat the cost (that's maybe 2 bucks wholesale) rather than opening up to potential litigation, because we all know they play dirty fucking pool and don't want legal scrutiny.
It is not my insurance's policy to test men for pregnancy when they go to the ER to treat migraine, which is where this happens to me the most. We probably also shouldn't be testing sterilized patients for pregnancy.
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u/30CrowsinaTrenchcoat Jul 31 '26 edited Aug 01 '26
I let them know ONCE and then let them do it anyway and then report them for insurance fraud :)
I havent had to pay for a single one of those tests. I also do not communicate to the medical facility that I am reporting them for insurance fraud. I let my insurance company know that they have done a test they knew they shouldn't do and I also report them to the proper local authority.
Edit: Thank you for the awards!