Is this fraud?

I attended an outpatient program earlier this year. Three hours a day, three days a week for 8 weeks. These were group sessions led by a licensed therapist. There was also a psychiatrist who we got to speak with once every two or three weeks regarding medication. I assumed this was just part of the outpatient program, that we get to speak with this psychiatrist. I saw them maybe 3 or 4 times in the whole program.

After my program is finished, I get billed from the company that facilitates the outpatient program. No issues, I pay the bills.

However, over a month after my program finishes, I start getting billed from an entirely different psychiatric medical group which I have never been a patient of, and my explanation of benefits state that I received inpatient services! I never even heard of this practice, never called them, was never a patient.

I look them up online, and one of the doctors who works at this psychiatric medical group was the same psychiatrist that I had seen in my outpatient program.

Okay, maybe there was somewhere in the contract of my outpatient program that stated that they could separately charge for these psychiatrist visits. BUT, at no point was I ever inpatient! I only was part of the outpatient program. And on my insurance portal, the claims are for every day of my participation in the outpatient program.

So I was billed for the outpatient program, which was right and fine, but now I am getting billed as if I was also inpatient! This has to be some kind of fraud, right? Even if they could charge separately for services, they only should have charged separately for 3 or 4 short consults (and most of them were telehealth), not for almost 60 different days. And they should have never claimed that I received inpatient services.

I tried calling the psychiatric medical group, but they say that I have to call the place that offered the outpatient program since they do the billing (which itself sounds sketchy). Then when I call the outpatient place, nobody answers the phone and I have not gotten a call back after leaving a message.

Is there a place I can report this or have it investigated? Are they allowed to do any of this? In the USA, if that matters. Thank you.

submitted by /u/Incredicoaster
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