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I-Team: Medical Billing Errors Could Put Health At Risk

FITCHBURG (CBS) - Imagine being charged for dozens of medical procedures you never had, or doctors you had never seen. This story might make you take a very close look at your next medical bill.

Errors on billing statements can be common. Some experts believe up to 80 percent have some type of mistake.

However, the problem is not just a financial burden on patients and taxpayer-funded programs like Medicare. It can also put someone's health at risk.

Just ask Joan Mullahy, who spent several weeks trying to clear up a slew of mistaken charges on her medical records.

In February, the Fitchburg retiree was reviewing her Medicare statement when something caught her eye.

"I realized I didn't know who some of the doctors were and had never received the treatment," Mullahy told the I-Team.

Mullahy immediately called Medicare, and was then instructed to call Mass General Hospital, where she supposedly had the medical procedures.

However, a customer service employee said none of the mysterious doctors' visits showed up on Mullahy's record.

At that point, she forgot about it, chalking it up to some kind of misunderstanding.

And then the next stack of bills arrived in May, stunning Mullahy. When she reviewed the documents, more than 60 procedures at Mass General had been falsely billed to her account.

A large portion of those costs had been picked up by taxpayers through Medicare coverage. But the bills indicated Mullahy could also be on the hook for thousands of dollars.

She figured someone had stolen her identity, so she contacted Fitchburg Police to file a report.

"I was very angry, frustrated, and sick to my stomach," Mullahy said.

Even worse, Mullahy was due for a mammogram. However, she discovered the payment for the procedure might be rejected because her mistaken records showed she'd already had one in 2015.

The financial nightmare had now grown into a health risk.

"I'm not going to sit back and allow this to happen while my health is compromised," Mullahy expressed.

But despite her best efforts, Mullahy had trouble getting answers about the mistakes and how to get them resolved.

After she contacted the I-Team, Mullahy received a letter from Mass General about the issue. It revealed 67 claims were sent to Medicare and other insurance companies for patients other than herself.

Read: Letter From Mass General Hospital

"What happened on your account is extremely complicated and was the direct result of human error, and for this we apologize," the letter said. "Please know that as a result of the error made in the system, we have put the necessary edits in our system to prevent the issue from happening again."

Mass General told the I-Team the situation was an isolated, unique incident attributed to the growing pains of transitioning to a new billing process. It is the reason a customer service representative could not identify the mistaken charges the first time Mullahy called in February.

"As we continue to implement new hospital medical record and billing systems, we continuously look for ways to eliminate these mistakes and we remain committed to the highest standards of billing practice," read a statement provided by hospital spokesman.

Bentley University professor Steven Weisman credited Mullahy's persistence in correcting the errors. He told the I-Team her story is a good reminder to scrutinize billing statements instead of just skipping to the "what do I owe" portion.

But even when errors surface, Weisman said the complexity of the health care system makes it tough for patients to clean the slate. Those issues also drain Medicare of millions of taxpayer dollars every year.

"The fact that Joan was so diligent in trying to remedy this and still ran into road block after road block is a tremendous indictment of the system," Weisman said. "We have to be very careful monitors of our health insurance."

The letter Mullahy received said Mass General had started processing refunds to Medicare and would also make sure to notify her supplemental insurance company.

The letter promised her account would be cleared so "you have no issue with receiving the services entitled under your benefits," like the mammogram she had tried to schedule.

But it might be awhile before Mullahy breathes easy and puts the ordeal in the rearview mirror.

"It has been very frustrating and stressful," she said. "All these agencies are so large and acted like it wasn't a big deal. It was a big deal to me!"

Ryan Kath can be reached at rkath@cbs.com. You can follow him on Twitter or connect on Facebook.

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