Contact the office and request an explanation. You shouldn't be double-billed.

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Behind the Bastards did a [two part series ](https://open.spotify.com/episode/4VSRr1oGDILPZmHHdYJp22?si=PVnoFBoyThSCNKfcFOAGUw) [(YouTube Link)](https://youtu.be/E8q_MSCyxuU?si=oBaPpQYi7QWzDKRM) about how easy it is to scam private insurance as a provider and the companies don't care

For anyone thinking, "That can't be right, insurance companies love money," I just want to stress that the insurance companies really *really* don't care about fraud. They don't even investigate it 99% of the time. They make so much money by ripping off customers that it's simply not worth their time. They write it off and move to the next scam. edit: Just want to also point out that insurance fraud isn't a victimless crime because the insurance companies make up the difference in profits by raising all of our rates. However much you hate insurance companies, it's not enough. They're cancer.

not health insurance but home insurance. our fire restoration contractor quit a 6 months into the process. we found 25k$ in charges that were never done. insurance did not care. actually made our adjuster much more difficult to work with

Oh yeah, they hate it when you get help filing a claim. I got flooded in 1998 and had no clue how to evaluate my situation, so I hired some folks for 6%. Sure they took a piece, but it was well worth it at the time. Then I wrote off the 6% as a miscellaneous deduction for "expense of proving a claim". Public adjusters can be helpful, but the insurance company's adjuster will hate them because they consider it "inflating" the claim, but it truly isn't wrong, as long as your itemized claim list is accurate.

yeah it's gotten so bad we are in a lawsuit with that contractor and once that is over suing our insurance

In many cases, it's not their money. Most large employers are self-insured and UHC, BCBS, etc. acts as the administrator, not the insurer.

Having worked in the health insurance for 22 years, I'm going to tell you now this is incorrect. Every person on staff is required to take yearly training on how to spot fraud. They have entire departments dedicated to it. Most fraud with health insurance costs the COMPANY money, or do you really think they want to pay out on services you never recieved? What you pay out of pocket is your business, they really don't care what you personally pay vs their responsibility...but I've seen claims adjusted and refunds requested frequently. My last job with a dental insurance carrier would actually review quality of service, and if it did not meet expectations they would get the money back from providers and have the member retreated for free. There was an entire team including licensed dentists reviewing the services. I'm assuming you're comment is based on a negative personal experience, and I'm sorry to hear about that, nobody is perfect...but that is no reason to stereotype that "all" companies do that.

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Insurance companies are probably one of the most misunderstood businesses everyone has to deal with. One of the main issues is that some people you literally cannot charge a profitable rate that is also affordable to insure them -- leads to residual markets where all participating insurers have to take a loss to cover the expense of people who can't afford it. If an insurance company can charge you less than a competitor and still be profitable on it (law of large numbers) they will 100% take that market cap from their competitors. Florida home owners insurance is and has been a major issue, for example. disclaimer: I don't work in health insurance, which to my professional knowledge has massive issues beyond what I understand.

The thing that blows my mind is how I'd you are buying a car, most people do crazy research into it... but health insurance costs about the same as a car premium and people usually don't even read their benefits. I don't get it.

> people usually don't even read their benefits I've read my benefits. Firstly, I don't understand them, because they use specialized vocabulary, and refuse to explain. Whenever I think I understand, they use vagueness to hide what I'm actually entitled to. Secondly, they are 90% loopholes, or references to other documents that are inaccessable, or written for lawyers, or marked as "not to be used to determine benefits." Thirdly, the "explanation of benefits" is not legally binding. If I manage to nail them down to something, they just say that the *actual* benefits are explained in a tome of legalese that I don't have time to read, and would require at least a year or two of law school to understand. And lastly, of course, it hardly matters, because my options are to take the plan my employer offers, or to suck a bag of dicks.

You should definitely give the podcast a listen or at least look at the reporting done at [The Tribune](https://www.chicagotribune.com/2017/02/08/ohio-clinic-falsely-told-dozens-they-had-alzheimers-lawsuits-say/) or by Marshall Allen at Pro Publica. He also discusses reporting state by state where Medicare finds maybe like dozens of cases of fraud and private insurance finds 1 or 2 cases of fraud. In some states it's 0 yet there's been studies that show Private and Medicare insurance get defrauded at about the same rates. Because it's funded by taxes people actually are checking for Medicare fraud, for private insurance they just raise the rates cuz putting in a system to verify things further and find existing fraud is expensive. Back to the reward, do you know of anyone to have actually claimed it?

I agree 100%. Most "fraud" when I worked in commercial were typing errors, or other honest mistakes. But even something simple like stitches done in right hands when they were done in the left get people screaming fraud. Medicare is worse with legit cases, but Medicaid is hands down the most amount of providers upselling that you can imagine.

I literally spent several hours on the phone trying to tell an insurance company (Cigna) that I didn't see any doctor in a state almost 1000 miles away. In the end, they really didn't care. I made several attempts (phone calls). They could see the charge they paid to the doctor I never heard of, and they could see his practice, but they told me nothing would come of it. But, if you think this is bad, wait until Medicare becomes part of your life. Every new thing that Medicare or Medicaid starts to cover, spawns an entire industry of specialized fraud. Think Medicaid supply stores with home delivery, adult diapers, mobility scooters, diabetic testing supplies etc etc etc

Medicare insurance and commercial insurance are very different. Abuse in medicare/medicaid insurance is higher because ultimately the tax payer is paying for it. There's insurers like [Wellcare](https://www.justice.gov/opa/pr/florida-based-wellcare-health-plans-agrees-pay-1375-million-resolve-false-claims-act) (Florida) who were caught making FAKE CLAIMS under doctors just so they could collect more of their cut. It's actually a bit tricky finding the exact link because that year they got raided by THREE separate authorities, including the SEC for securities fraud. Commercial is a bit different as persistent fraud means they will need to raise premiums to remain competitive. Insurers frequently do things like automatically downcode (pay less) for visits, or they send warning letters that you're billing too high a level (frequent insurance abuse is to overbill the level) edit: as for your specific case I am quite surprised they don't at least send a request for medical records from that provider. Record requests are common.

You can make a lot of money telling the Feds about Medicare fraud.

Agree with prior posts. One of my prior job functions was requesting records from providers. However the out of state thing is more common than one would think, and it also blows my mind how many people with the same name and date of birth are through the same insurance carrier. So you can have John Smith born 1/2/34 in Arkansas and John Smith born 1/2/34 in Arizona. Somebody types AR for the wrong state and it takes like a month to straighten it out. The doctors office has to send a letter stating it was billed in error, then they have to submit a corrected claim showing no service, then insurance has to match the letter with the claim, then send to accounting department to either request the money back or withholds from future payments. It's a mess and overly complicated.

It's possible that my name and DOB matched someone else, actually it has happened before with state criminal history records. They don't care much about SSN matches either, initially. I don't have a criminal history in the state I live in, and have lived here 35 years. There's a guy in South Milwaukee with my name and DOB and he likes to beat women and steal "movable property". Caused me some grief getting a DL here because my state will attempt to match any criminal history by name and DOB, probably because people use fake SSNs. I literally had to get a letter from Wisconsin saying the socials don't match, so i could get a DL. Was told by state records people to "just carry the letter with you" to prevent the police from being confused, every single time they look you up. We had words through email about it and how that's not how shit works, and that I'd be communicating all this to my state and federal reps. They stopped communicating with me, but they fixed their database to have some kind of entry that solved everything.

Damn if thats how insurance companies operated overall I wouldnt be against the legal scammers, but unfournately thats quite rare.

Please explain this to me then. The ACA says that health care insurance providers must spend "85 percent of premium dollars on medical care and quality improvement activities." So it's obvious that they can only profit an amount equal to 15% of their premiums at most. So the only way to make a bigger profit is to spend more on health care. I.e., these companies want health care prices to go up, and then they can raise premiums and make more profit. That's the incentive. I'm not saying that they actively support fraud, but I am claiming that they lose money by trying to save money on medical care in the long run.

You can't blame them. If your profits are capped by government regulation as a percentage of what you pay vs what you receive, you're not going to dedicate a lot of resources to fight hospitals or pharmaceutical manufacturers when they overbill/commit fraud in the commercial sphere. You essentially ask insurers to spend money to lower their profits. At best you might see a bit of a drop in profit; at worst you could essentially destroy your business. Providers get too much of a pass in the US health care industry, [charging $500 for Tylenol](https://whyy.org/segments/inside-the-complicated-world-of-medical-billing/) or [$700 to push an IV](https://www.npr.org/sections/health-shots/2021/06/28/1007198777/a-hospital-charged-more-than-700-for-each-push-of-medicine-through-her-iv), just to name a few. And I haven't even brought up [evergreening](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680578/). If provider costs were regulated at all like insurers are, we'd see costs plummet.

I knew a guy who used to investigate on behalf of Insurance Companies. He said he was paid to follow people making suspicious injury claims and he would do so for a specified period of time to watch for any activity that would demonstrate they were faking or grossly exaggerating it. He caught nearly everyone, because they (companies) usually sent him on claims that were probable fraud. You don't hear about these investigations because if it was more widely known customers might go to other vendors, thinking they'd be challenged for honest claims. And because there's so much fraud and so few investigators they can't catch everyone. He said he had enough work to last him years, (some claims take that long).

I know someone whose DME (medical supply company) charged their insurance $60 for a sample can of similac gentle. The 8oz ones marked SAMPLE NOT FOR RESALE. Which the dme either got for free or bought for $10 max off someone on Facebook or eBay ( a lot of supply companies buy on eBay Amazon etc to save money then supply these second hand medical items to their patients and change insurance full price.) Oh also companies like nestle, Nutricia, and Abbott do not have wholesale prices. They sell to the medical supply companies at full retail (or like $5-10 lower than the $275 retail price for 4 cans of formula.) The dmes then add their handling fees on and end up charging insurance like 200% of retail for these supplies. It would have been cheaper for the insurance company to reimburse the patient to buy directly from the retail website for full price than to pay insurance.

Yeah. I just had a claim hit my insurance company from two years ago that was so vague and sketchy that I can’t believe they even paid it. I contacted them to let them know it was fraud. They didn’t even care at all. As long as I don’t get a bill from the scammer for “my portion,” I don’t care and am dropping the issue because I’m losing brain cells trying to get BCBS to care.

I did insurance billing for 10 years and they absolutely care about fraud. The fines for false billing are a tremendous money maker and in some cases, the person blowing the whistle also gets paid a huge fee.

Yup, currently a medical biller and they make sure you file everything perfectly or they’ll deny your claims. I’m still trying to fix a six month backlog of claims because a certain insurance company credentialed a doctor wrong and tried to blame me for it. Took four months to find the error and fix it, and they’ll still fighting tooth and nail to deny the resubmitted claims that were originally correct. And on the off-chance that you manage to sneak something past them, they’ll catch it on an audit and royally fuck you.

Agreed, in the end they will get around to caring about the money, BUT sometimes it seems the left hand doesn't have a clue what the right is doing! I started getting checks from my insurance, reimbursing me for out of pocket payments that I never made (the in network provider was billing out of network, yada yada, they were figuring it all out but never billed me incorrectly). I notified insurance and the provider several times and they kept sending them, and I'm talking thousands of dollars! I held on to the checks, never deposited, cashed, or endorsed them, and sure enough, about 6 months later, I start getting demand letters for overpayment, demanding I repay them within a short time (do they not verify the status of the payments? I never touched them!). I reached out and told them no, not my job, they can cancel their checks. Funny thing is I kept getting more checks. Then more demand letters, then more checks, etc. In case it wasn't clear, this is all from insurance, not the provider. Now the kicker. We stopped seeing this provider, stopped getting checks, stopped getting demand letters, and started getting letters of UNCLAIMED FUNDS! They wanted to reissue expired checks!

Yes, I had an issue with a dr ordering me something I specifically declined and then billed the insurance for it. They didn’t care.

Because they know the ignorant masses will blame poor ppl for their expensive insurance premiums instead of the actual culprits

And then fire the therapist. Don't contine going to a place where they have dishonest practices.

Speaking as a therapist, this is the only correct response in the thread. Lots of accusations of fraud, greed, etc. but it was likely a mistake. I've done this once in my five years of practice and it was a small, easily fixable mistake. Essentially, our scheduling system says an appointment has been completed unless we mark it as a no-show. Sometimes we get pulled into administrative stuff and forget to change it to a no-show immediately. After X amount of time, our billing department bills the appointment. I forget to mark it before the billing dept sends the invoice to insurance, then it'll get double-charged just like in OPs case. Call and they'll cancel the insurance claim and you'll be good to go.

If the doctor didn't mark it as a no-show, why did OP get charged for missed appointment fee?

I don't know how their billing system works, but it is not unlikely that marking the no-show to trigger a direct bill to the client and marking it to prevent billing the insurance company happen on separate forms, in separate places. Therapist offices are generally small businesses and I've noticed a lot of small (and not so small) businesses with record keeping systems much less intuitive and more labyrinthian than one might expect.

Your billing department bills a service without verification of visit documentation? That will be super fun at audit time, hope your organization doesn't bill Medicare or Medicaid! (Was a medical compliance analyst for years)

Big facts! Shouldn’t be submitting claims until documentation is complete in case of an audit, which they (insurance) commonly do. Worked in billing for a small outpatient mental health clinic for seven years.

This was my first thought too. No signed notes, no billed services.

Yes but if she got charged the missed appt fees then someone correctly marked it somewhere and maybe it’s only happened to OP twice now but how many times has it happened to everyone else? Honestly if this is a therapist who specializes in patients with adhd then this is predatory. A person with ADHD is already more likely to miss appts and 100% the least likely demographic to check their bills and what’s being billed to their insurance. So really how many times has this lady been paid twice?

I hate these greedy doctors!!

Most therapists outsource their insurance billing to companies that manage this stuff for them. She probably didn’t go out of her way to commit fraud—although anything is possible, but 90% of the time someone fucks up like this, it’s incompetence rather than malice.

Right it's not worth being kicked off an insurance panel or getting a complaint to their licensing board. Very likely an accounting mishap.

Incompetence or malice? Does it really matter? The net result is funds being obtained fraudulently. If a restaurant charges you double are you going to say "Well, it’s OK because they’re just incompetent"?

Neither is ok but isn't malice worse? Like there's a difference between a car accident and me running somebody off the road.

Both carry penalties, as they should, with the penalty being more severe if malice can be proven.

Of course it matters. Nobody is saying it’s okay, they’re saying it’s an easy fix because if it was a mistake, you can just call them and they’ll refund you and update their billing procedure so it doesn’t happen again. If it’s deliberate fraud, they’re going to ignore you and keep doing it, to you and others. Do you really not understand the difference that mens rea makes? We don’t give people the death penalty for manslaughter but we also don’t give them a pat on the back and let them go free. Nuance exists. 😂 Use your thinking brain.

> Does it really matter? It's the difference between "I hate these greedy doctors" and "I hate our fucked-up insurance system."

>Incompetence or malice? Does it really matter? The net result is funds being obtained fraudulently. It does matter, as it is by definition impossible to fraudulently obtain funds without the intent to do so, therefore if the funds were obtained through a mistake due to incompetence they were not obtained fraudulently. Fraud - "Wrongful or criminal deception **intended** to result in financial or personal gain."

Incompetence means no fraud. Fraud requires intent.

Therapists usually aren’t doctors. Edit: I understand that it’s hard for you to comprehend hence the downvotes. But a doctor in a healthcare setting is an MD that went to residency training. A psychologist with a PHD may call themselves a doctor but they aren’t a clinical doctor. They are a clinician with a doctorate degree. Also many therapists don’t have PHDs either. I recommend you find a safe space if my comment hurts your feelings

This reminds me of a joke I read here on reddit:  Guy1 : I need a doctor!!!! Helpful stranger: I'm a doctor in mathematics.  Guy1: My friend is dying! Helpful stranger: Minus one.

Amazing meme as well

No, a PhD is a doctor by definition To differentiate the different types of doctors, it is better to refer to MDs as physicians

You're giving me big time Captain Holt vibes and I love it. https://www.youtube.com/watch?v=_5QoYZuMILo

It’s literally DESCRIBING a doctor.

Therapists arent medical doctors. Psychologists ARE doctors, a doctor is someone who holds a doctorate, it is NOT a medical doctor, thats one of many types of doctors. Also medical doctors can either hold a MD or a DO.

Idk why you’re getting downvoted for this.. most therapists have a masters degree😂

Whining about getting downvoted then suggesting people are getting their feelings hurt. I can't.

Some MD's are just soooooooo mad that other people (who ARE doctors) can be called "doctors." Honestly these are the docs you want to stay away from. They care more about themselves and their grasp on their titles.

Many psychologists don’t have phds either, so

I think you’re overlooking what the letters mean. MD means doctor of medicine, PhD means doctor of philosophy. In the UK at least, psychologists are DClinPsy which means Doctor of Clinical Psychology. The DClinPsy is a clinical, not academic, doctorate so of course a psychologist is referred to as Dr in a clinical setting. They are not a medical doctor (MD) but they are a doctor of clinical psychology (DClinPsy). A lot of DClinPsys also have phds, these are separate qualifications.

Not every therapist is a doctor. Psychiatrists are, psychologists are not.

Psychologists have a PhD, so they do often go by doctor.

I've met a few greedy private practice owners, but this is probably just an employee making $60k or so a year. They're not doing this because they're greedy. It's most likely just a clerical error.

>Never attribute to malice that which is adequately explained by stupidity. Stupidity may be a bit extreme here, but my point is that I agree, this is probably 90% chance of a mistake and 10% chance of them trying to milk the insurance company.

On contact your insurance company and explain you were already billed. That is what the EOB is for, to inform you what the insurance company is paying for so that you can say "Whoa, that isnt what actually happened at the appointment!" or "I never saw that doctor, maybe they made a typo?". They will get to the bottom of it.

Contact your insurance first, have a rep on the line as you question the office. Do that if you want a fast fix and answers

Most offices will just correct the error without much debate.

Call your insurance, they'll be interested.

She might have an organization doing the billing so they might just billed as normal. Ask her about it.

This. At least open the dialogue in a manner like this, it might resolve the situation without burning the bridge with the therapist. If you're seeking therapy and already put in the time/money with one particular therapist, it would be expensive (time cost and money cost) to transfer care. So the smarter option is to try to avoid that. If you find out that the provider actually is being sus, well that's a bridge to cross once you get there. But definitely stay informed and know what to do, in the event that this is the case. (Lots of comments on this post with good answers/strategies regarding this.)

Just call them and ask. Maybe the office billed it "automatically" as they were expecting to bill that day and overlooked it. Might not be nefarious but could also be them trying to have it both ways. Just talking to them will be your best bet.

This is fraud and definitely illegal almost everywhere on Earth. Charging a cancellation and/or rescheduling fee is fine (and even expected), but charging for services and procedures not offered/done is fraud. Call your insurance ASAP and tell them everything you just told us.

u/Alternative-Thing960 If you plan to keep seeing this therapist, call her office first and ask about it. If they can't or won't resolve it quickly, then call the insurance, but don't burn bridges before you have to. If you were planning to drop her anyway, then I guess it doesn't matter as much.

This. As a podiatrist, I do charge for missed appointments. (\*unless someone has a *really* good and plausible reason) ...specifically because I *cannot bill the insurance for a treatment that didn't happen*

Yeah, that's the standard for most businesses. Some even hide it as "deposit" and make sure to include that it's not refundable. It's an insurance (ha!) in case people cancel 30 seconds before their appointment. Even some barbers and stylists have adopted it (and I don't blame them).

Forgive me for the stupid question (wrong sub right lol) but what's the purpose of this? I've had numerous emergencies or meetings that go long and I've had to reschedule appointments and pay for this very reason. What does it achieve?

Fkng THANK YOU!!!

Not necessarily fraud if it was done in error. OP should still contact insurance and the therapist’s office, though.

or it was an honest mistake by their billing person and not some unhinged con to get that sweet 5$ insurance reimbursement…… good lord

That's a costly mistake that happened twice. Fraud doesn't need malicious intent behind it to be considered fraud. A mistake happening once is one thing, but happening twice is a pattern.

Don’t assume an issue. Call and ask. It could be a mistake on their end or no mistake at all.

Dispute this. If the insurance audits, it would be considered as a fraud cause there was no chair time. 

Contact her and let her know what’s going on. Some therapists don’t handle their own billing and mixups like this often occur

Often therapists outsource to a third party app now too. So it's likely the app person being bad. Definitely just let her know, takes less effort than a Reddit post!

Exactly! And mostly all you get is ignorant responses from confident idiots. 

It's probably a clerical error - medical billing has become so complicated nowadays that it's virtually impossible for any rational human being to consistently get it right. Definitely contact them and get it straightened out.

Let's not assume malice when it could be incompetence. I am a therapist and direct bill insurance companies. My first thought on this is that the person doing the billing was stupid and billed the credit card for the missed appts and then later one processed the insurance claims. Some insurance companies do cover missed appts, most do not. But you can still file for a missed appt on the insurance that doesn't cover no shows. I'm curious if this is potentially what has happened and your insurance was just prompted for the co-pay. Regardless, call your insurance first and find out what is actually covered on your end. Then call the therapist office and find out what happened on their end. Then have them correct it. Then go find a therapist with competency in ADHD because text reminders are virtually zero effort but very important until a set pattern of meeting occurs. A treatment goal can be "to not need text reminders" Good luck internet stranger

Was $120 the total fee?

No it’s fraud. She’s committing insurance fraud.

>really struggle with remembering appointments I used to have the same problem until I discovered Google Calendar. With calendar and "alert 1 day before" and "2 hours before", that rarely ever happens anymore.

The Dr can charge you a cancellation fee for not showing up, but cant charge you for the entire visit and bill the insurance.. that is double dipping for sure. You need to let your insurance company know that you were not present for those two visits so they can start an investigation.

Nope they can’t bill if services were not rendered to insurance

Before you contact anyone, double check to make sure the date you paid for and the date she billed insurance for are the same *service date*. Some providers submit several claims at once. Thus, it could be (for example) that on April 1st you missed a session that you paid her $120 for *and* on April 1st, she submitted claims for past sessions (but NOT for the April 1st appt) and what you're looking at is the claim submission date, NOT the date of service. I've seen this happen before.

Sounds very unethical to me! As someone with ADHD, my coping strategy is calendar reminders on my phone with multiple alarms notifications (with sound). This is what works for me: One a week before (so I can organise time off with my boss, if needed) One 2 days before in case I need to let my husband or family know One the morning of One 15-30 minutes before I need to leave to get there on time

And then one more when I need to be out the door so if I get distracted, I am reminded to actually leave.

Great advice :) I haven’t tried calendar reminders but the Apple reminders app wasn’t not very helpful for me as it would send one notification then I’d forget that I was reminded until it was too late. I now have an app called Due - Reminders & Timers which works great. It pesters me with notifications every 5 mins up to every hour. It’s $5 but I’ve found it incredibly useful so I try to tell others about it.

No, it is not. She can come after you for the fees, but billing the insurance company for a service not provided is insurance fraud. Remind her of this and your intent of reporting it should she pursue payments, and find another therapist.

Illegal but probably a computer error because it's automatic to send bills out. Their computer isn't accounting for not showing up. I'd just bring it to their attention.

You have plenty of answers to your query, but I'd like to suggest an app to help you remember your appointments. The app is called Due Reminders. [This](https://www.dueapp.com/) is there website. It's a highly versatile and user friendly app. It will remind you x amount of hours/minutes before your appointment and keep reminding you at set intervals. I couldn't live without it.

This app is amazing! It has absolutely helped me immensely. Most likely the best $5 I have ever spent.

Nope that's insurance fraud. But you can get charged for missing your appointments if not cancelled in proper time. My sister is a psychologist,and this happens all the time to her. She is loosing money when you don't show and don't give her a reasonable amount of time that you are cancelling. That time you booked is her commodity that she is selling,she could have filled it with someone else

There is likely a clerical error. Some therapists use 3rd parties like Mentaya to simplify billing to insurances for themselves and for you. These can be set to send your superbill to your insurance at 4pm every Monday for your appointment automatically for, again, their and your simplified billing process. This is used to improve speed of reimbursement but it may, like in this case, lead to an accidental billing of the insurance. Obviously, there could be fraud going on, but more than likely it’s an overworked therapist who made a mistake.

I agree, innocent until proven guilty

Am a therapist. It's easy to accidentally file a claim for an appt that was not kept, especially if you have an outside booklet. I see people asking how to fix it all the time. I would start by calling the office and asking them to explain it. Odds are, it was a mistake. If they don't fix it, then call your insurance company to report it.

Im not sure how long you’ve been with this therapist but it raises a a red flag to me how she handled a symptom of what you hired her to help you work through. The fact that she didn’t think to text you and just immediately charged you twice when your diagnosis makes it hard to keep track of appointments likely means she’s either bad at her job or corrupt. Im not pulling a Reddit knee jerk and suggesting you fire her based off this super limited piece of info I have but I’d keep it in the back of your mind at least

Sooooooooooo I would absolutely get a new therapist. My therapist texts me if I don’t log in within five minutes because she’s concerned. She also increased my appt reminders. So if absolutely reach out to your therapist and ask about the double billing and see if they can fix it. If they don’t THEN take it to your insurance and 100% get a new therapist because at that point it’s purposeful fraud and this person should be reported

Its insurance fraud. Call your insurance company. ALL of our insurance premiums are effected by this.

yeah, that's wack. not a professional in any means, so I could be wrong, but I'm pretty sure she can either charge you for late fees, or charge the insurance for her services, not both. I would love to believe she made a mistake, but she seems... wrong. to say the least. also, for whatever it's worth, start looking for a new therapist. you shouldn't be working with someone who's both so unwilling to work with you, and screw with you/insurance. I have some differing issues than you, but most of my therapists have been willing to text or email me a heads up like "hey, you're late, is everything okay?". tbf, I rarely was late, and have some more, uh, "serious" issues (not making light of yours, or some bizarre mental health competition, just. you know. I don't know your entire diagnosis, but mine can have some life altering repercussions which is all mine were concerned about). but what I'm saying is there's a good chance you can find someone who's willing to work with you and give you a heads up if you miss stuff, instead of, you know, being a jerk and possibly commiting insurance fraud.

Hmmm it’s seems like it should be illegal… but I think more context is needed. How many missed appointments? Is $120 for a bunch of missed appointments. If that’s the case than I would think that the fees are to penalized you for likely cancelling with no notice and the insurance claims would be to reimburse the therapist for lost wages. Since they would be unable to fill that spot with no notice. I’m not sure though.

Not from the US, but from my country we can’t bill insurance for services not rendered. It’s fraud. You can call the office and simply ask because it may be a simple error. We always issue a reminder for appointments and that appointments cannot be cancelled / rescheduled 24 hours prior to appointment or the patient is liable. However; if a patient is reasonable I do not charge. Everyone is human and I’m happy to reschedule if something comes up. I also don’t really follow through with defaulters as much as it’s a signed agreement because it’s not worth my time. I can’t force someone to take their appointments seriously after we have sent multiple reminders via text and call. It’s frustrating because we could have booked someone else in that session. However; you need to implement calendar reminders and alarms. This part is something you can actively start working on.

It is not legal and the insurance commissioner would love to hear about it so they can audit her billing practices

Thats insurance fraud Im pretty sure. The point of the fees for missed appoint is because they cant charge your insurance for services rendered because no services were rendered.

No, OP, fraud is not legal.

For missed appointments some therapists have an additional late fee that you will get charged (in your case maybe $60 an appointment) on top of normal costs. If you signed a contract look over it and you will be able to tell if you agreed to it. This could also be a clerical error or if she is part of a practice she might not even be doing the billing. Either way I would just ask and clarify.

She’s a predator change therapists.

I am also a CPA and a healthcare CFO. Agree call the business office and tell them to file a corrected claim and return any money they received. Billing for work you didn’t do is the number one healthcare insurance fraud. Hopefully it’s just an administrative mistake.

The cancellation fees seem warranted but billing for appointments that never took place is wrong and you should talk to the insurer.

They should be audited.

Billing insurers for services not rendered is fraud. They may treat it as a mistake but you should still report it to them. They all have fraud departments (typically called Special Investigations Unit)

It may have just been an accident. No one is perfect.

That's insurance fraud. What you want to do with that is up to you.

If you failed to provide notice that you needed to cancel the appointment within the required time frame (usually 72 hours but policies do vary) then they can still bill your insurer.

Ignoring the double-billing, get a different therapist if yours doesn’t understand enough about adhd to realise she should send you a reminder… My psych sends me an email/sms the day before and also one 5mins before the call is due to start…(she doesn’t do in-person meetings…)

Yeah they should be sending at least one reminder. My psych office sends so many reminders that I now habitually ignore them because it’s like “you made an appointment” then “your appointment is in one week” then “your appointment is in three days” then “you have an appointment today”. When you do weekly or biweekly appointments it’s a bit excessive lol.

I'm a licensed mental health counselor. From what I understand each session is way more than the cancellation fee and certain clients health insurance allows us to bill them even when the client does not show up. I'd still call your insurance company to make sure the date of service is correct.

Why don't you use your phone and set reminders?

I had reminders set. I actually saw the two reminders go off earlier in the day. All day in the back of my mind I was thinking “don’t forget therapy!” Then right as my appointment ended I looked at my clock and realized I’d worked right through my appointments. It’s just how my brain fails me it’s infuriating sometimes. I’m a US tax accountant for a public accounting firm and the two appointments I missed were the first two weeks of April. I was working 70 hour weeks and was so frantically trying to get all my clients filed before the deadline my brain was not working well for personal life stuff.

Just let her know what happened. It's not legal and it's more than likely that she didn't mean for it to happen. Plus, if she were to be audited and didn't have session info from the date you were mistakenly billed she could face some problems.

I would contact your insurance company first and then the doctors office. A missed appointment or late cancelation fee is there to help comp losses for skipped or last minute canceled appointments. Her going around and then charging your insurance as if she had treated you is fraud

Double dipping doesnt seem legal, no.

Is insurance fraud legal?

First thing look at the contract you should have signed before treatment. There should be a missed session rule. See what it says. Then I would contact the therapist directly and ask about it. It's very likely an accounting error. It's not worth $120 to intentionally cheat a client when they can lose their standing on the insurance panel (which is probably a large source of their income) or be reported to their governing agency.

That’s fraud.

Insurance fraud.

No, it's insurance fraud. However: Contact billing office and tell them to review the chart notes and CPT codes for that day. Kindly inform them it must be an honest mistake as your therapist did not see you nor provide session/ treatment on that day. Remind them kindly that while you are 100% sure this was an honest mistake like a date inputted incorrectly, it's their responsibility to ensure its corrected that as soon as possible to avoid future liability. 2) request itemized office visit dates/ charges from them to review dates and times and they match your records. 3) escalate to your state's insurance division as well as your insurance company if not quickly - let's say two weeks, in reality it should take 1 day- . Do let the billing office know that your intent is on the first step however you may be looking for a new therapist if you do. Going forward keep meticulous records with this office of days, times you had a session. I'm sure it was an innocent mistake, but depending on how your therapist if he's a solo practitioner, or her billing office and office manager react, you might need to go therapist shopping.

A therapist cannot bill for a service they did not provide, irrespective of the reason. Let your insurance company know.

> really struggle with remembering appointments 3+ reminders on your phone. One the day before so you remember it's tomorrow, one a few hours ahead so you can arrange your tasks, one alarm at the time you need to start your prep work like turning on the computer and getting logged in. Add more alarms as necessary. Set all the alarms as soon as you know when the appointment will be.

When you get your Explanation of Benefits call the toll free number on it and tell them that it was a no show fee. They can pull the billing code internally and compare it to her coverage and handle it. It will be much easier for them than you

You shouldn't be double-billed. Hopefully it's just an oversight.

Can you contact your state's attorney general? You may not get a reply for 6 months but you can ask them to audit the therapist. This sounds shady AF. She provided no services, yet she made a claim against your insurance as if she did.

That’s messed up I’d be pissed! 

Illegal, inform your insurance company right away, or you could be dragged into this.

This is what the federal government likes to call “insurance fraud” because she is billing your insurance for services not rendered. She also made it extra spicy by billing you the missed appointment fees and copay on top of it. She can’t bill both you and your insurance, that’s also a form of insurance fraud. I would politely point out the ‘mistake’ to her and give her the benefit of the doubt. Once.

No, it’s fraud.

That's fraud

Double billing is fraud.

Doesn’t sound legal to me.

Regarding your latest update: I wouldn't use session time for this if you can avoid it. See if you can call the office staff directly, that way it can be resolved without taking away from the time with your therapist. Although maybe also let her know, since she may need to start keeping closer tabs on them.

Good advice from others, I would like to add look for a new therapist.

no, this is ~~patric~~ 'MURICAAAA *eagle noises* *gun noises*

Do Not Pay. Unless results from insurance Fraud case determines you have liability.  FIRST. REPORT IT!  Call your insurer and/or If you have Medicare/Medicaid call/text/email  Medicare fraud line and/or your State's Medicaid equivalent!   Medicare:   https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse  State by State Medicaid reporting:    https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforConsumers/Downloads/smafraudcontacts-oct2014.pdf  Insurance Fraud help:.   https://www.nicb.org/how-we-help/report-fraud

Most people in the comments saying this is illegal really are assuming. In my experience, most therapists have a cancellation AND late policy and a fee may come with no-shows or late clients after a certain point. You still may be charged when instances like this occur because you didn’t respect the therapist’s time and give a heads up in the agreed upon time frame. As long as those stipulations are in the contracts you agreed to sign, which they probably are, then yes. It’s legal. and give a heads up if you’re running late or cancelling or not showing up at all instead of worrying about whether the charge for your no-show is legal. Wild.

Crazy that your therapist who is seeing you for your ADHD doesn't even try to contact you lmao

This. I wasn't in therapy for anything like this, and I always got an email.

Assume a good-faith mistake. Call and ask. No, she should not be paid twice for a service she didn't have to provide. I'm guessing the things that made you seek therapy make this call feel really scary, but I assure you they'll be kind about it. And in the slim off-chance that they're not, get a different therapist, because that's nuts.

Side note: I have had depression for decades, and brain trauma as well. I also struggle to remember things. Sometimes, I even forgot to go back and get the tea I’ve been steeping in the kitchen. But this is 2024, and people like you and I don’t get to have excuses anymore when we can just put the appointment into our phones. Do yourself a favor and start setting alarms and stuff for your appointments. Your mental health will improve, and that’s what I want for you, which is why I bothered to write this. Best of luck, friend.

I would send the information to the insurance company ASAP but be prepared to find a new therapist.

It sounds like you need a remembrall

I’m not allowed to charge insurance for services I do not provide. In fairness, some recurring claims are billed automatically so collecting the provider is a good first step.

No it's one of the other. Dispute the claim with the insurance company.

Set reminders on your phone. It's the only way I keep up these days! My memory just isn't good enough and I can get distracted very easily. The tools to help are too easy to use to ignore. 

Do you always keep your phone on you? If so, use proton calendar app and write down your appointment, a notification will tell you when you have to go. You can put periodical stuff too. It solved this issue for me, it's great. It is also safe afaik. It's open source, free and without ads. Hope it helps. This aside, the double charge is surely bad, ask her for an explanation and a refound

No. I worked as a massage therapist at a chiropractor’s office and they would bill insurance for the people who didn’t need massage as part of treatment and would pay out of pocket for an HOUR of massage every week. Double dipping - not cool. And while I’m firmly in the “mind your own business” camp usually, this is something I would report.

>could not bill my insurance if I missed the appointment because she did not provide any service that's a solid maybe. if you missed an appointment, well now the doctor isn't earning pay for the time they put aside for you. So they may be able to charge for the service since that time isn't occupied by another patient, even if you didn't go. It may be that the late fee is on top of the service charge.

It’s illegal if they accept two payments for a single session.

The only part of this that has me suspicious, is it would have had to been marked as a “no show” in order for you to get billed a no-show fee. If they did that, there is no way to accidentally bill the insurance. Not saying the provider is the one that made the error, but not sure how both could happen “accidentally”.

The whole point of cancellation fees is because insurance won’t pay for the missed time, hence they are charging you instead. If they also charged insurance successfully, then you should request a refund.

Therapist here. We cannot bill insurance for cancelled sessions. This is insurance fraud.

No that is insurance fraud.

Call their office and address it directly. Most likely it’s an error on their part stemming from their system automatically billing stuff, but there’s always a chance it was intentional and that they are defrauding the insurance company. Either way, it’s not something they’re allowed to do and they need to make it right.

Look at it like this. If you make a big stink about it someone may open some kind of "case" and best case scenario you get a lil checky check while this Dr. Gets to move practices to a different side of town. If you've lost substantial amounts of cash try to get it back, that's your prerogative. But nothing else will happen to this Dr. Most likely. Just for sake of argument, all the office has to say is it was a billing mistake the automated system sent out two bills and one or both were accidental depending on whose breathing down their necks and how hard they're breathing you'll probably be compensated.

No, it's not legal. That's why they charge you (more than your copay), because they cant charge your insurance.

All of this could be solved by calling the office and asking for an itemized statement.

Just tell them to refer you to a new therapist and tell them hoe out of line they were. They'll give you your money or lose a patient

Don’t go in throwing accusations. It’s entirely possible that your therapists billing is done by a different party (very common in US healthcare). Double billing is illegal but it’s also reversible if caught early enough

My surgeon did that to me! Because of the type of cancer I have I had to have my breast implant removal surgery at the hospital instead of his surgery center. Because it was a medical necessity my insurance covered it. BUT, he charged me his full price, minus the OR and Anesthesiologist. I still ended up paying HIM over $10,000.00! I have asked them for an EOB but was told they don’t keep records like this. My gut tells me I have been double charged. What do y’all think?

Contact your therapist. The whole point of a missed appointment fee is that they can’t bill insurance for that. Probably a mistake.

I don't know the rules in your country but in Germany it's fraud if you bill insurance for something that hasn't taken place and you can be sued for it.

Absolutely, but when they are questioned it is going to be a "clerical issue." Which honestly it really may be

Often times is billed with a cpt code showing no show that the insurance denies or they have it set up to auto bill. This is most frequently a clerical error and no malice intended... but do call your insurance SIU line to report this.

You are correct, it's one or the other she doesnt get both. Step one contact her office and demand an explanation for the double charge. They owe you a refund. Take a COPY of your Credit card statement and a COPY of your insurance records, do not take originals. If they give you a hard time about refunding one of your accounts. Dont argue, and make a fuss. Simply take your paperwork and leave. Start looking for a new Mental health provider. While you are doing that, contact your state's Department of Health and file a complaint against them. Double billing is illegal and they could face fines or an investigation to see how many other people the office has done this to. In most cases this a fraud and if serious enough could result in jail time.

My therapist did this to me for years. I would get statements saying i went to four appts when i only had two. He kept double charging me and when I questioned him abput it he blamed it on his bookeeper and saud he had two pstients with the dame name. Total bs

I haven't had to 'remember" an appointment in years. I put everything in my Google calendar with alerts the night before or morning of. Take some stress off yourself!

Just a thought on your therapist: if you are seeking therapy for ADHD, why isn’t a way to remember appointments hole in as part of your treatment plan? Do you discuss missed appointments and how to address that issue, because I’m guessing it’s not just therapy appointments that you miss? I am not sure if this is the case, but it seems that your therapist is charging you for the issue you are seeking help for but not attempting to help you resolve the symptom. And speaking as someone who is in the same ADD boat with forgetting appointments, Google calendar or the iPhone calendar with reminders is my savior. Highly recommend.

My therapist doesn't do this to me. Think its an awareness to not add any further anxiety or stress to someone seeking therapy for it. The issue is there's no notification that an appointment is coming up. Or communication that billing will occur for missed appointments.

It's fraud. Oppsy-doopsy, we made a mistake fraud or on purpose fraud is still fraud. $120 in fees sounds to me like multiple instances, which makes it more likely to be on purpose.

No Stupid Answers says, "yes".

She broke contract with her insurance. If you report her, she'll likely get kicked off the insurance panel, and possibly get reported to her licensing board for unethical behavior. She might even get sued by the insurance company.

I think we should give therapists a new name. I glanced at the title and was wondering wth "The Rapist" would've been charging you money for

I think if they billed for services they can’t charge you extra for missing an appointment and if they bill your insurance that’s fraud

More than likely auto-billed, sort of like autopay.

I don't have an answer to the double dip bit, but whenever I've been late to a therapy appointment, or clean forgot about it...my therapist has texted me. She even once moved my appointment to three hours later, 30 minutes into the missed appointment, just so I could be seen that day still, and not have to pay the missed appointment fee. Might wanna rethink therapy with your therapist.