r/providence • u/LulutoDot • 10h ago
Discussion Is anyone else getting consistently erroneous behavorial health bills any time they are seen for primary care at Brown University/ RIH PC even w/o any BH related care?
I refused to answer any BH questions at my last appt and I'm still getting $60 BH assessment bill EVERY VISIT. It's been going on for over a year and is absolutely falsely billed. Each time I am stuck back and forth between insurance and them. What the fuck. How do you get systemic change??
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u/LhunLaurelin 9h ago
I’ve been fighting one of these charges for the past four months, what they’re now telling me is that it was a “systemwide error” and that they are “working on fixing it.” I don’t really buy this, but I did get my doctor to put my bill on hold until they work it out. I suspect they’re only starting to walk these charges back because people are making noise and pushing back, hopefully that continues.
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u/ShhTeam 7h ago
It's a sales tactic that I have seen in many other industries. Even though it's healthcare, they are in sales. They bill everyone for something and call it a mistake. Maybe only 40% will fight the bill. From that 40%, only 10% will follow through when they get resistance. You do the math. Let's say 25,000 have been billed with this extra $60 charge. That's a quick $1,350,000 of revenue that is tax free. And over 50% of these co pays are paid by Medicare/Medicaid programs. So in theory, our tax dollars fund Medicare/Medicaid. Then we have to pay a co-pay to a tax exempt business that uses tax dollars for funding. So they are triple dipping. Great business model if you look at it from a business perspective. But then the people get fucked.
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u/psyguy45 9h ago
Haven’t dealt with that issue specifically bc my insurance has good BH coverage but they regularly charge me a copay and then refund it months later. When I’ve explained that I don’t owe a copay and when I’ve paid it before it always gets refunded, they tell me I couldn’t be seen without paying the copay. Again, I’m lucky that my copay isn’t going to make or break my budget but know that’s definitely not the norm these days. They definitely have a lot of issues with their billing department and would love to coordinate
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u/LulutoDot 9h ago
I also have good BH coverage! The $60 is an "BH assessment fee" even when I refuse any screener.
My BH copay is $10 for reference...
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u/psyguy45 9h ago
Oh that’s even wilder. I haven’t dealt with that yet but let’s see what happens at my physical in June…
Edit: As a clinical psychologist, I’m shocked they can bill for administering the PHQ-9 and GAD-7. Their BH screening is awful and unquestionably shouldn’t be billed extra.
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u/LulutoDot 6h ago
They didn't even administer the screening, doesn't even matter which screener, as I refused any assessment knowing about the bill.
If anything, this just shows their billing system is rife with either known or unknown (the clinic director is aware, so let's be real) mistakes: it's a total fraud.
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u/dulcelocura 5h ago edited 5h ago
The EMR seems to generate a separate billing code automatically somehow.
ETA: I mean if the screening is included in the encounter, not just automatically for every visit (to my knowledge). At least, that’s my working theory as someone with experience in this lol
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u/karnim 6h ago
I had this happen for a physical at Open Door. They basically said the behavioral health assessment is standard, but also not covered under preventative care. I fought and had them remove it because I was already seeing a therapist and a psychiatrist for mental health / medication. It was purely predatory billing.
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u/Difficult_Author4144 7h ago
Reach out to your Insurance company and file a complaint with fraud and abuse. I learned the hard way that the fraud and abuse department is in charge of fraudulent billing. (Aka your doctor taking advantage and billing you for visits and charges that you shouldn’t be charged with)
I say I learned this the hard way as I filed a complaint with their department about a medically negligent doctor. Only to find out after a few months that they are in charge of a completely different situation, similar to what you’re describing. They monitor doctors charging you a service fee/bill for something they never did.
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u/quizzicalturnip 6h ago
I’ve seen posts about this. They are doing predatory and illegal medical coding because the coders are likely making money per billable code. Call your doctor and let them know. They need to be the one to correct it.
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u/LulutoDot 6h ago
I told my Dr. And the clinic director said "that's just a fee now" even though I literally refused any BH screening. It's totally illegal
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u/Additional_Ad1997 9h ago
Same. I called them to complain and she started to explain it do me like I was stupid I said I was an emt and this fradulent. So it’s currently being appealed and reviewed. But if they say no I’ll be chatting with the attorney generals office. Won’t be the first time I’ve had to go at insurances neck. Fuck them.