Avoiding outrageous hospital overcharges
Profit seeking hospitals are charging patients around $10 billion more a year in over payments. Much like your cell phone bill one might think that some hospitals deliberately try to keep bills difficult to read. Even though it can be an exhausting task knowing what to look for can help you reduce your bill.
Hospitals cheat patients out of billions of dollars each year. Some experts believe that some of the overcharges are simple mistakes but many are intentional.
Whether a mistake or intentional some of the charges can be absurd or simply never administered at all.
One auditor’s results found that some 90% of the hospital bills have serious errors, estimating the overcharges run up to $10 billion per year.
Other experts estimate overcharges average $1,300 per hospital visit making up about 5% of the total hospital bills.
Some examples are charging $90.00 for a 70 Cent IV or calling a box of Kleenex a mucus recovery system and charging $129.00! Towels and sheets should be a part of the room charges and not individual ad on charges.
Health insurance plans have different contracts with different payment schedules so there is no one rate sheet to audit. Hospitals may be adversarial about your audit, regardless of the difficulty or time involved it is more than worth it to audit your bill. If you have a deductible or Co-Pay the excess charges will come out of your bank account but just as important is the fact most health insurance plans have a maximum benefit amount so these errors will reduce your lifetime maximum benefit amount.
Some actions you can take
If your hospital stay is not an emergency know in advance what your policy covers and how much it pays. Review all the exceptions and exclusions to know exactly what the policy does not cover.
Correspond with the hospital billing department in advance find out what the charges for your room is and exactly what is included. For example it the room charges don’t include Kleenex etc you can take your own. Ditto on your regular prescriptions surely your cost would be cheaper than the hospital.
Make sure that all of the specialists who will be administering medical treatment are in your insurance plan network?
Either you or someone you trust can keep a tally of tests, medicines administered and all treatment in general.
You will receive an Explanation of Benefits (EOB) or on Medicare a Summary Notice don’t shred it because on the top it says; “This is not a Bill”. This is your tool to audit your charges matched against your insurance plan what it pays and what you will pay? Regardless of what anyone tells you it is not necessary and you should not pay the bill prior to leaving the hospital.
Now you can compare the tally you keep while in the hospital to the EOB or Summary Notice. Surely you will find items you do not understand and when you do call the billing department and your insurance provider for explanations. When you see terms such as miscellaneous fees etc things you have no idea what they are request itemizations. You may have to appeal to higher authority to get these itemizations. Always ask for an itemized bill and your medical records in order to compare them with what you have been billed for. Regardless of the state of residence the state requires the hospital to provide you with an itemized bill.
Date: April 17, 2012
Categories: Health Articles