Although I have never worked in a doctor's office, my best friend manages an office of a surgeon. Yes, they (the doctorS) submit a number for reimbursement, assuming they will get a portion of the amount billed. Each insurance company has their own little payment schedule as to how much some service is worth. So, yes, the doctors pad their bills, knowing they will get less. Not much different than car dealers starting at a higher price and taking what they get in the end.

I also know that the different insurance are noted for rejecting claims by doctors... giving them a hard time....but in most cases, after contacting the company, the payment is made to the doctor. Cigna has the worst reputation for rejecting doctors' and patients' claims.

I don't think the doctors misrepresent what they have done, as much as they bill the max and hope for the best.

I also know that the doctors' medical malpractice insurance carrier audit the doctors for billings, note taking, procedures, etc. I am not sure how often Medicare/Medicaid does audits.

I would like to believe that doctors are not so guilty for padding bills - hospitals and nursing homes are another story.

All that said, I really don't have any first hand information. Just second hand.