Going over your bills will not be a waste of your time. The need to check, and recheck, every bill you received can not be over-stated. Every industry out there has been known to deliberately over-bill their customers. Estimates put the price tag of medical over-billing alone at costing Americans $270 billion a year. While the medical industry is best known for over-billing their clients, they’re certainly not alone. Each and every company that sends you a bill has most likely been accused at some point of over-billing their customers. Catching these billing errors isn’t exactly easy either. AT&T has been accused of over-billing prepaid phone customers, who don’t even receive a bill. They do so by adding extra time to a phone call, after the call has ended, resulting in an annual estimated over-billing of almost a million dollars. Without sophisticated equipment the average prepaid customer would never know they were being over-billed. Some bills are a little more blatant, such as cable companies charging for pay-per view movies that were never watched. Another industry ripe for over-billing is the quick auto repair and oil change business. Thousands of customers have reported being over-billed for work that was never even done.
While nearly every service provider out there over-bills, the biggest culprit of all is the medical industry. Even though few Americans are adequately insured, the billion dollar a year industry still feels the need steal money out of the pockets of people who are already going to be in debt, maybe for the rest of their lives, because of medical procedures. It’s estimated that about eighty percent of all medical bills contain errors, with the average error being $1,300. And it’s a fact that every one of these billing errors favors the hospital, not the patient. The firm Medical Billing Advocates of America specializes in medical over-billing. They have found some of the most egregious examples of medical over billing such as; charging $20 per aspirin, $15 for a disposable razor, as well as a $12 “oral administration fee” (the fee charged when a nurse brings you your $20 aspirin). Medical Billing Advocates of America also found one hospital charging $445 for a 10-milligram vial of Norcuron. The price billed for the exact same vial in other hospitals is around $18. One particularly ridiculous case they worked they found $33,000 worth of fraudulent charges on a $39,000 hospital bill including a $1006 charge for a toothbrush (the hospital later said it was a typo).
Medical Billing Advocates of America believe that 80% of all medical bills contain errors.
Here are some of the most common over-billing charges occur from;
Duplicate billing can happen in numerous different ways, and is usually very difficult for the lay person to spot. In some instances you will be billed for a surgery, and for the use of the surgical tray and equipment. These charges are already rolled into the cost of the surgery, and shouldn’t be billed for separately. Other duplicate billings occur when blood is drawn and tested for multiple problems. While the multiple tests need to be billed, most people also get billed multiple times for the blood being drawn, which only happens once. Other reasons for over billing include both the doctor and nurse charging for medication, as well as medication being charged for when prescribed, as well as when administered.
This is usually a deliberate attempt by the hospital to pad your bill. What will happen is a persons regular doctor may show up at the hospital to check up on their patient. While there the doctor will prescribe medication, usually generic. The hospital will then fill the prescription using a brand name drug which may normally cost ten times the amount. Another example of upselling would be when you are being tested for a certain ailment. The hospital may know that a blood test will adequately test for a certain condition, yet they will send you for more invasive, as well as expensive, testing which will cost you quite a bit more.
Operating Room Charges
This simple fraud costs patients almost more than any other. What will happens most often is that patients are charged exorbitant prices for things like gloves, masks, and sutures. All of these things are already wrapped into the per minute charge for the operating room. The per minute charge of the operating room is also a major component of fraud. Many times patients are charged for an hours worth of time for a surgery that may have only taken twenty five minutes. There are cases of auditors seeing the exact same operating room being billed to two, or even three, different patients at the exact same time. When the hospitals are caught double billing they most always use the “billing error” excuse to cover their deceptive billing.
This is probably one of the hardest frauds for the lay person to spot, simply because most don’t understand what is incorporated into the price of a medical procedure. An example of an unbundled fee is when a woman is charged for an epidermal, as well as the $350 charge for the IV. What most people don’t understand though is that the IV is already bundled into the epidermal procedure. This happens in every part of the hospital, from the emergency room, to the operating room, and even in the room you sleep in. There are numerous reports of people being charged for sheets, bedpans, and toiletries, all of which are bundled into the cost of the room.
This is one over-billing incident that falls more in the user error category, as opposed to fraud. What will happen is that upon your arrival the attending physician may call for numerous tests to find out what the problem is. Even if after one or two test they find the problem, all of the additional test requests are still in your chart. The person who handles the billing will see the test requests in your chart, and assume they were carried out. You will end up paying for some very expensive testing that you really have no idea whether or not you received.
Believe it or not, just a simple typo could mean the difference between a $5000 hospital bill, and a $50,000 hospital bill. We all make typos, I’ve probably made 10 in this article so far. The difference between me, and a person working in the hospital billing department, is that I’ll go back and check for typos when I’m done. Even then, I may still turn in a finished product with a typo. It happens to the best of us. The problem is a typo on a medical bill can greatly affect the total cost of the hospital stay. While one simple set of blood work may have a billing code of 36745, a more elaborate, and expensive, set of tests may have a billing code of 37645. If both of the codes are even somewhat similar tests, not even a professional auditor may spot the mistake. This is such a common, and overlooked, mistake that auditors have gone back and found instances of a female patient being charged, and paying, for a prostate exam.
As you can see there are many ways for you to be over-billed on a hospital stay. So what should you do? The very first thing you should do is refuse any hospital bill that isn’t itemized. Always ask for an itemized bill, this is the only way to see exactly what you’re being charged for. Next you’re going to have to figure out exactly what you’re being charged for. You may have no idea what the previously mentioned “oral administration fee” is. You may end up spending hours of your free time on the phone with the billing department trying to decipher their intentionality confusing medical jargon. It beats paying thousands of dollars for procedures that you’re not responsible for though. Once you have your itemized, and interpreted, bill, now you have to go through every single charge to find out whether it’s erroneous or not. This will be another grueling process which may take days. It may also mean the difference between having to file for bankruptcy or not. Once you finally have a bill in your hand that makes sense, that is it actually reflects the charges you should pay, now you need to get it to the billing department and have them recreate a correct bill, a bill where all of the erroneous charges are removed. Even then, you’re still not done jumping through hoops. You still may have a medical bill of hundreds of thousands of dollars staring you in the face. Now is the time you need to start negotiating. Hospitals, doctors, and clinics are notorious for over charging for their services, and will quickly negotiate a better price. Medicare usually pays around forty cents on the dollar when it comes to medical bills; insurance companies around fifty cents. There’s no reason a person struggling to make ends meet should have to pay an inflated price so a multi-billion dollar insurance company can pay a reduced one.
If You Find A problem With Your Medical Bill
The first thing you need to do is Call Your Provider (and take notes from the call), explain the error, to the best of your abilities, and ask the person in the billing department to make the correction. Make sure to keep a record of each call you make, including time of call , the name of the person you spoke to on the phone, and what you were told. It’s very possible that these first steps are all you need to do to resolve the billing matter
Well, if that doesn’t work, call and ask for account representative or of that is unavailable to you, go directly to the fraud department of your insurance company.
If all that doesn’t work, here the next step, contact your state attorney general’s office or the consumer-protection agency for your state
If it’s still not resolved by the time the next bill arrives, here’s what you need to next, you should pay the portion of the bill not in dispute. And it is very important that you take a look at your credit reports if your billing issues are not resolved within 60 days. It’s after the 60 day mark where credit problems can be headed your way, where unpaid balances can be reported to at least 3 major credit reporting agencies. We don’t want you to be surprised that your credit score suddenly tanked, we want you to be informed and take the appropriate course of action in order to save money and NOT have your credit score take a hit!
Your Best Choice To Resolve a Medical Bill Error
Contact; Medical Billing Advocates Of America
If all of this sounds like too much work, you can always contact MedWisebilling.com, for all your medical billing needs. A company like this will get your itemized bills from the hospital, and then scour them for errors and fraudulent charges. They will also negotiate with the hospital on your behalf for a reduced price. If the company is unable to lower your bill, which isn’t very likely, you owe them nothing. If they can lower your bill they only charge you a small fraction of the amount your bill was reduced. Often leading to the patient saving tens, if not hundreds, of thousands, of dollars.