Litigating Overbilling 2 Years Later
A 6-year-old girl fell and cut her ankle open a half-inch. Her mother sought treatment at an Out-of-Network clinic due to concerns about going to a hospital during the pandemic.
The doctor unnecessarily enlarged the cut to three times the original size and placed six stitches, billing a staggering $19,225. This amount seemed exorbitant, especially considering the injury could have been treated with a steri-strip or band aid.
WellRithms review and repricing recommended a justifiable payment of $1,091.56. Dr. Ira Weintraub requested the operative report for documentation to substantiate the charges, and it was provided 16 months after the date of injury.
Review of the operative report raised questions. The description did not match photos the mother provided of the initial injury, showing just a 0.5-inch scrape. Additionally, the notes contained government-related references seemingly added to rationalize the charges.
The patient was balanced billed, and the WellRithms Shield was utilized protecting the patient’s family from any additional financial or legal responsibility. The physician is now suing WellRithms for the balance.
WellRithms remains unwavering in its mission to bring transparency and fairness to the healthcare reimbursement landscape, challenging those who attempt to exploit the system.