[mindslight]

The way medical billing works is plainly fraud, but the people who are successfully defrauded don't end up knowing any better. For everyone else it's merely attempted fraud, and if you (forcefully) call out the fraudsters they'll bargain their bill down to something more defensible and/or find someone else to pay it.

I'm nearly done dealing with an instance of this myself (for someone else). Had a $1k copay that was legit per their "insurance" plan. The hospital also sent a fraudulent bill for another ~$2k rather than doing the work of figuring out how to bill "insurance" for it. Told them we'd pay in full once they presented a complete set of non-fraudulent bills. Half a year later, with me holding the hands of both bureaucracies, they finally were able to get "insurance" to pay that second bill. I told them we were ready to pay the $1k legit copay, and they told me they had taken care of it months ago using some internal charity fund. The system is an utter joke.