Don’t assume that your hospital bill is correct. Mistakes such as duplicate billing, code errors and unrequested items are all too common. Why pay more than you have to?
The last thing you probably feel like doing after a stay in the hospital is to fine-tooth comb the confusing computer codes and odd abbreviations on your bill. But it’s worth the time and effort to review hospital bills carefully–you may be shocked at the number of costly errors you’ll find.
And if you think you don’t have to worry about hospital charges because you’re insured, take a close look at your policy. Most insurance companies require that patients make a co-payment (usually 20 percent of the total bill). Even if your policy says it covers 100 percent, that usually means it will pay for what the company considers to be “reasonable and customary.” Anything above that amount comes out of your pocket. Besides, the more insurance companies have to pay for hospital bills, the higher the premiums they will charge their customers. So we might all pay less for health care by taking the time to study hospital bills carefully and questioning any errors.
Should you have any trouble understanding your bill, you can call the hospital billing office and ask for a “simple English” explanation. Yet, frankly, there are certain kinds of errors that even the most sophisticated consumer might not find. Charges for inappropriate treatments or unnecessary supplies and lab work are hard to spot. So don’t be afraid to ask your doctor to review the bill to verify that it accurately reflects your treatment.
There are several areas in which hospitals often make mistakes. In fact, overcharging is common enough for some companies to offer a reward of 25 percent of the savings to employees who find errors in their hospital bills . The mistakes outlined below are the cause of more overcharges than you’d imagine, so keep them in mind when checking your bill.
• If at all possible, you or a family member should try to keep a list of all the services and products provided to you while you are in the hospital. That way, you’ll have something to compare the final bill with.
• Review the dates of your stay to determine that they are
• correct. You don’t want to pay for a three-day hospital stay if you were only there for two days.
• Double check the telephone charges, room supplies and, especially, the medications and tests. Sometimes a whole series of items and tests are billed to you even if you never used them or they were canceled by your doctor. NOTE: Frequently, consumers complain that a hospital has charged for a whole surgical or emergency kit even though only a few items from it were ultimately used. Unfortunately, according to the Attorney General’s Office,this is a legitimate expense because these kits are sterile and have to be kept sealed until they are needed. Once opened, the rest of the kit is unusable.
• Be suspicious of charges for services labeled “miscellaneous.” Always ask for an outline of what they are.
• Check for double-billing (being charged twice for the same thing).
• Occasionally, hospital staff may lose or misplace a patient’s records, x-rays or tests results. If this happens to you and your tests are repeated, insist that you not be billed for the cost of the replacements.
• Keep in mind that all the doctors who attended you, including anesthesiologists and radiologists, will bill separately from the hospital. So there shouldn’t be any charges for their personal services on your hospital bill.
If you do find an error in your bill, contact the hospital’s business office or patient accounts supervisor immediately. Explain the errors you found, and don’t let them talk you out of your claim with platitudes like, “Don’t worry your insurance will cover it.” Next, let your insurance company know about the errors. Put everything in writing and keep copies. If you are unable to resolve your billing dispute with the hospital, send your complaint in writing with a copy of the bill to the Office of Consumer Affairs of your state’s Attorney General’s Office.
If Jane Doe had gone over her bill carefully, she could have saved over $490.00. Look over the sample hospital bill below. Can you tell where she was overcharged? See errors at the bottom of the page.
Errors: (1) Double-billing for chest x-rays.
(2) routine urine and chemistry tests were done earlier that week in a doctor’s office, not the hospital.
(3) the pharmacy fee is for sleeping pills refused by the patient.
(4) the stapler and suture clip should have been covered under surgical supplies, not billed separately.
(5) the pharmacy fee includes drugs canceled by the doctor;
(6) the final room charge is in error, as the patient was already discharged 10-25-94.
(7) the total is wrong–it should be $1944.76, an overcharge of $76.29 (the path specimen was added twice).
Look at bill again.