Whistleblower Wins Suit Over Medical ...

Whistleblower Wins Suit Over Medical Billing Fraud

There are 17 comments on the NBC San Diego story from Feb 21, 2008, titled Whistleblower Wins Suit Over Medical Billing Fraud. In it, NBC San Diego reports that:

A San Diego Jury found that a La Jolla medical group overcharged patients by padding insurance bills.

Join the discussion below, or Read more at NBC San Diego.

Gary Ingram Sr

San Diego, CA

#1 Feb 21, 2008
Millions of people in america don't have medical insurence because of te cost. Hospitals blame it on uninsured patients not paying when they recieve treatment. I blame it on greedy Insurance providers, Doctors and our government not doing enough to keep the price of helth care affordable.
Healthy Girl

Hackensack, NJ

#2 Feb 21, 2008
Thank you for this story. I am a patient of Dr. Silver and always wondered why he ordered so many tests on me.
Sue Kimble

Englewood, CO

#3 Feb 21, 2008
Shame for North County OBGYN!No wonder Ins. Premiums for the un insured are so high and can't afford them!!!!!!!!!!This facility should be serving prison time as well.They plan on appealing the verdict!Get Real!Do the crime serve the time!
Jorge

Irvine, CA

#4 Feb 22, 2008
This is why health insurance is so expensive. These doctors should have to pay back every penny they stole.
Auntie D

Lone Jack, MO

#5 Feb 23, 2008
Congratulations to Mr. Bulow and Atty. Strecker. So refreshing to find people with ethics and morals in this day and age.
Great birthday present! ;)
Tiffers

AOL

#6 Feb 25, 2008
GOOD. MORE PEOPLE NEED TO TAKE ACTION WHEN THEY SEE OR HEAR OF SOMETHING LIKE THIS. MEDICAL BILLS ARE HIGH ENOUGH WITHOUT DOCTORS GOUGING THE PATIENTS. WE ALL SPEND A LOT OF $$ ON
MEDICAL INSTURANCE AND DON'T WANT TO BE RIPPED OFF BY DOCTORS.
IF YOU ARE A DOCTOR AND READING THIS: LISTEN, IF YOU DON'T THINK YOU ARE MAKING ENOUGH $$ HERE IN THE U.S. PLEASE GO SOME PLACE ELSE. AMEN.
FABismonte

Danville, CA

#7 Feb 28, 2008
I cannot believe that the crooked medical group still tries to defend itself by claiming "no fraud" and no claim for payment from insurance companies. Thank goodness for Attorney Marc Strecker.
RealFrauds

Aliso Viejo, CA

#8 Mar 1, 2008
Maybe premiums wouldn't be so high if doctors like these weren't being sued left and right. Doctors are one of the few respectable careers left out there, and unfortunately, its just not a viable option for our youth to go down that path because they're not making any money. The idea that you can work your butt off your entire life, and have it all taken away just like that is completely absurd.

If doctors make 15 bucks per visit how are they supposed to make a decent living? So all the lawyers can go screw yourselves, they're the only ones out there making money. As for other jobs out there, businessmen and lawyers can make exponentially more; how's that fair?

so before all you go complaining about being over billed and blaming the doctors, figure out how much money they're really making off your visit and go question the insurance companies.
Think About It

Aliso Viejo, CA

#9 Mar 1, 2008
Hate to say it, but the jury clearly got this one wrong. So people like you, Sue Kimball, ought to actually step back and take a full, objective look at the situation before you start calling for blood.
FABismonte: what, exactly, can't you believe? Do you know the facts of the situation? Have you done background research? How, exactly, do you know that North County's claims aren't valid? Unless you can give a solid answer for that, then your opinion is absolutely worthless (and I suspect that you can't).
Do you think that these doctors were ripping off the insurance agencies? Nonsense. The fact is, insurance rates are so high, nowadays, that doctors can't even make money anymore. The doctors are as much the victim here as anyone else. If you want a villain in this story, you can go ahead and look squarely at the insurance companies and Dr. Bulow. The former for essentially extorting doctors into paying astronomically high insurance rates (which, ultimately, is the fault of the money consumers who engage in frivolous lawsuits against doctors). The latter, Dr. Bulow, is to blame simply because he appears, in this case, to be a sleazy opportunist. As far as I can tell, it has been a good while since the man has actually been employed- it seems that he'd rather sit around all day and live off of ill-gotten lawsuit money, which he collects from the hard-working doctors that keep people like you and me healthy.
What do you people want? When doctors are sued constantly by patients and unethical doctors alike, it becomes only a matter of time before they all leave the business. Do you want to live in a society where our best and brightest learn, from an early age, that a career as a doctor simply isn't feasible? I know that that's certainly not what I want.
Former Patient

Albuquerque, NM

#10 Mar 19, 2008
I was well taken care of by Dr. Silver and all of the staff at North County OB/GYN last fall. I had a high risk pregnancy during the last trimester and during each visit I was given a lot of time and all of my questions were answered. They took better care of me than I did! They work hard and I am so grateful to all of them! I have reviewed my billing and it is all appropriate.
a patient

United States

#11 Mar 20, 2008
I have been a patient for both Dr. Bulow and Dr. Silver. Let me tell you "Think About It" that I DO know the background information on this case. You clearly DO NOT if you think that Dr. Bulow:
"As far as I can tell, it has been a good while since the man has actually been employed- it seems that he'd rather sit around all day and live off of ill-gotten lawsuit money"
Did you know that Dr. Bulow set up shop in the building next to NCOBGYN and took a huge portion of their patients with him (including myself). He has no OB partners and sees each patient, every visit, every time and delivers 100% of them personally.
NCOBGYN has made Dr. Bulow's life and professional experience hell for the past two years because he tried to fix problems within the practice. I am proud to know him and to be his patient.
As for Dr. Silver, he not only was a total jerk, he was a complete chauvinist. Not a great quality for an OB. He also screwed up my billing and that was over 5 years ago.
Bibi

Irvine, CA

#13 Aug 14, 2008
It is a disgrace that doctors who could make good money the honest way are so greedy that they steal money from patients and make all our insurance rates go up. They should be ashamed, but instead they try to say its OK.
consumer chick

United States

#14 Jul 20, 2009
What, was this posted by Emily Litella?(old Saturday Night Live reference).

The $15 is the patient COPAY honey. That is NOT what the doctors make on that office visit. The office visit balance is paid by insurance company....and if it is a "consultation" it is billed for far more and the patient billed 10-20% of that. Before ranting about the opinions of others, know what you are talking about.
RealFrauds wrote:
Maybe premiums wouldn't be so high if doctors like these weren't being sued left and right. Doctors are one of the few respectable careers left out there, and unfortunately, its just not a viable option for our youth to go down that path because they're not making any money. The idea that you can work your butt off your entire life, and have it all taken away just like that is completely absurd.
If doctors make 15 bucks per visit how are they supposed to make a decent living? So all the lawyers can go screw yourselves, they're the only ones out there making money. As for other jobs out there, businessmen and lawyers can make exponentially more; how's that fair?
so before all you go complaining about being over billed and blaming the doctors, figure out how much money they're really making off your visit and go question the insurance companies.
Pharmgirl

AOL

#15 Jul 20, 2009
Don't blame the doctors. They have to put up with things, I could never deal with. I know there are a few quacks out there, just like a few bad politicians, lawyers,judges, and so on. There's nothing any more valuable than a good doctor, but for a doctor to be good, you need to be a good patient, not someone who is rude, sarcastic, and cursing and hitting at the doctors and nurses. I have seen this happen, and no doctor should have to spend their precious time on these timewasters. It's people like this that can cause a death by demanding so much attention. And the hell they have to go through to help their patients get workman comp when they know they are badly injured, and these claim adjusters accuses them of of trying to defraud the insurance cos. Only very few cases turns out bogus, but they really like to play this too. My doctor diagnosed me as having a severly torn rotator cuff injury, due to my job, and guess what the insurance adjuster says, it's only a shoulder sprain. What a lie, the doctor is the one that knows, the MRI tells it all, and my pain is not a shoulder strain. These thieves and liars goes over the doctors head, and patients suffer. I have heard that for every denial they do on a workman comp claim, they get a 6 figure bonus, and I believe it. These people are rats, them and the dirty lawyers split your workman comp benefits that rightfully belongs to you. I have wrote my Senator, Governor, Insurance Commissioner, and guess what, have not heard from any of them. Maybe they are where SC gov Sanford was. If anyone has been screwed as bad as I have by the workman comp system send me and e-mail at [email protected] I want to see a whistleblower on this, just how bad and deceitful this workman comp nightmare is.
Joseph - Pa

Harrisburg, PA

#17 Oct 13, 2010
My Doctor and I had a conversation about billing. He told me what hurts many Doctors is - some Doctors tell their patients the actual costs for services - services that do NOT have a variance. BUT, this is a big but - they have a third party billing unit that scrutinizes the services who then decide to 'go after' more money. The patient seldom challenges these 'EXTRA' charges - just pays because they are either confused, tired, ignorant, actually feel their Doctor made a mistake of stated price or just do not have any fight in them.
These billing people are 'BADGERS'!!!
Folks start to question your bills - ASK the Doctor to be clear of service costs and THEN ask hiim to notify the billing department - and most of all get it in writing.
Joseph - Pa

Harrisburg, PA

#18 Oct 13, 2010
Pharmgirl wrote:
Don't blame the doctors. They have to put up with things, I could never deal with. I know there are a few quacks out there, just like a few bad politicians, lawyers,judges, and so on. There's nothing any more valuable than a good doctor, but for a doctor to be good, you need to be a good patient, not someone who is rude, sarcastic, and cursing and hitting at the doctors and nurses. I have seen this happen, and no doctor should have to spend their precious time on these timewasters. It's people like this that can cause a death by demanding so much attention. And the hell they have to go through to help their patients get workman comp when they know they are badly injured, and these claim adjusters accuses them of of trying to defraud the insurance cos. Only very few cases turns out bogus, but they really like to play this too. My doctor diagnosed me as having a severly torn rotator cuff injury, due to my job, and guess what the insurance adjuster says, it's only a shoulder sprain. What a lie, the doctor is the one that knows, the MRI tells it all, and my pain is not a shoulder strain. These thieves and liars goes over the doctors head, and patients suffer. I have heard that for every denial they do on a workman comp claim, they get a 6 figure bonus, and I believe it. These people are rats, them and the dirty lawyers split your workman comp benefits that rightfully belongs to you. I have wrote my Senator, Governor, Insurance Commissioner, and guess what, have not heard from any of them. Maybe they are where SC gov Sanford was. If anyone has been screwed as bad as I have by the workman comp system send me and e-mail at [email protected] I want to see a whistleblower on this, just how bad and deceitful this workman comp nightmare is.
WRITTEN BY ONE NAIVE GIRL!
Joseph - Pa

Harrisburg, PA

#19 Oct 13, 2010
Think About It wrote:
Hate to say it, but the jury clearly got this one wrong. So people like you, Sue Kimball, ought to actually step back and take a full, objective look at the situation before you start calling for blood.
FABismonte: what, exactly, can't you believe? Do you know the facts of the situation? Have you done background research? How, exactly, do you know that North County's claims aren't valid? Unless you can give a solid answer for that, then your opinion is absolutely worthless (and I suspect that you can't).
Do you think that these doctors were ripping off the insurance agencies? Nonsense. The fact is, insurance rates are so high, nowadays, that doctors can't even make money anymore. The doctors are as much the victim here as anyone else. If you want a villain in this story, you can go ahead and look squarely at the insurance companies and Dr. Bulow. The former for essentially extorting doctors into paying astronomically high insurance rates (which, ultimately, is the fault of the money consumers who engage in frivolous lawsuits against doctors). The latter, Dr. Bulow, is to blame simply because he appears, in this case, to be a sleazy opportunist. As far as I can tell, it has been a good while since the man has actually been employed- it seems that he'd rather sit around all day and live off of ill-gotten lawsuit money, which he collects from the hard-working doctors that keep people like you and me healthy.
What do you people want? When doctors are sued constantly by patients and unethical doctors alike, it becomes only a matter of time before they all leave the business. Do you want to live in a society where our best and brightest learn, from an early age, that a career as a doctor simply isn't feasible? I know that that's certainly not what I want.
Folks, take a real close look at the people in the billing departments - they are the ones finding ways to charge the extra money! I have challenged this twice in a Doctors office - the Doctor was surprised when I questioned him about bills I began receiving after I paid "IN FULL". Then a billing employee began giving some talk no intelligent person would understand or accept. The Doctor ordered her to declare my account paid in full. If you are so easy to be parted from your money - blame yourself and the billing department.

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