In the New York Times article, “The Medical Bill Mystery,” reporter Elisabeth Rosenthal overlooked one important point about the lack of information in medical bills: It enables unscrupulous healthcare providers to get away with fraud.
By listing only medical codes and not providing common-language descriptions of the services for which the patient has been billed, healthcare providers can make false claims – for instance, upcoding and unbundling treatments and services – and no one knows. Patients could be the best guardians against such fraud, because they know what services were provided.
However, in our experience as whistleblower lawyers, patients are rarely whistleblowers. The format of medical bills explains why.
Standardized medical bills with detailed descriptions would not only benefit patients but also would help reduce Medicare fraud and thereby benefit all taxpayers.