I received a bill in the mail for a Pediatric Medical Group claiming I owe a balance on a service after the birth of my child 18 months ago. The billing is very vague and lists a doctor and dates and some insurance math but gives me a $97 balance. After logging on to my insurance website I have receipt of already paying for this particular doctor/date ($134). When I called the company they told me that my insurance company did an audit and decided to retract $54 from the amount they covered and now I owed $97. Now when I googled this medical groups name, google is filled with articles about fake bills sent out on their behalf etc. I hung up with this company and called my insurance who could see all of my charges and payments and said not only was I completely paid in full but there was absolutely no note or indication that there was an audit on my account and had their been it would be noted/I would have been notified directly by them.

(Also want to add — several months ago I received a letter that the system that my doctor uses to house medical info had been compromised so it wouldn’t be impossible for a third party to have some of my care information)

Now, I’m basically 95% sure that this other bill was bullshit but I’m wondering – would an insurance company ever audit 1.5 years later, retract money to a provider and then the provider would come after the patient? Is this scenario even real?

submitted by /u/linzkisloski

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