Provider inflated the billing code. They stated they spent 45-60 minute with me for a new patient consultation when they only spent less than 5 minutes with me. Should I pursue reporting them for insurance fraud even though I’m not directly out any money for the claim?

All I owed was a flat copay that I would have owed regardless of the billing code, but that's only because I already reached my deductible. I know this issue is a systematic issue and not unique, but am I expected to be complacent about it or report it when it happens?

Will reporting it now undermine future reports later? I've been defrauded far more money by other providers in the past and I anticipate it will happen again. I'm scared if I report this small claim to the insurance they'll deprioritize or blacklist me from future complaints when I really need their help.

What will actually happen if I report them?

I found my insurance's online fraud reporting form. One of the questions is if I contacted the provider about the issue already. Is this something I should do? How should that conversation even go. What should I be telling them to do to fix the issue?

The claim was processed immediately and the provider has already been paid by the insurance. Are they supposed to resubmit the claim?

submitted by /u/Individual_Radish829
[comments]

See also  (California) Medi-cal / covered CA / Sharp mess