Avoid Costly Medical Bill Errors & Mistakes
Posted by Cap in Personal Finance |Half a decade ago when I was 19, I was sitting in a hospital waiting room as a family member underwent a medical procedure.
Spying a cute girl of similar age across the room, I proceeded to try and “look smart” by picking up the local newspaper so I can pretend to read it — but of course my real intention at the time was to have an easier means to take the occasional peek at the cute girl.
Ah. The shaping of a future creepy stalker. I’m not sure why I added this story to the post, but, there it is.
What really caught my eyes that day though was a story in the local newspaper about “killer” medical bills – medical billing errors that were so drastic that it affected the entire financial well-being of a family. Apparently, a fat-finger mishap occurred where the hospital billing department mistakenly typed in the wrong billing code for the procedure done in the hospital, and the minor clerical error resulted in a fatigue-inducing, long drawn-out battle with the hospital over the medical bill.
According to a Medical Billing Advocates of America, 80% of the medical bills contain errors in them. Occasionally the problem get more confounded by confusing Explanation of Benefits from insurer and hospital summary bill that’s lacking in details. Coupled with these and many other factors, it’s little wonder there’s an entire industry out there dedicated to helping consumers deal with medical billing errors, overcharges, and underpayment by insurance companies.
Because of the high percentage in probability of errors, you should always request an itemized bill from the hospital and compare it closely with your EOB from the insurance company before you pay your bill. If you spot anything that you have questions about, take the time and contact your insurance company or the hospital/physician’s billing office.
Common medical bill errors as listed by Consumer Reports:
Duplicate fees for tests and procedures.- Incorrect date of service – nothing beats being charged for a room on the day you weren’t even there.
- Inflated room charges for incidental items such as sheets and towels (these should already be included in the room charge).
- Human errors – as mentioned above, a mistaken keystroke could result in the wrong billing code.
If you’re in a situation where you can’t seem to resolve a medical billing dispute with your insurer or hospital, you might want to consider outside help from a billing advocate, though you should be aware that billing advocates usually charge an hourly fee plus a percentage of any savings.
With the potential of errors that can cost thousands of dollars, scrutinizing your bill should always be a requirement. When I told my family about the story I read in the paper, we went through our medical bill carefully when it arrived and thankfully it was without errors. My family, of course, promptly asked me what business I had reading the paper, to which I responded defensively with a long exposition on how I love to read and seek knowledge. I’m not sure why they didn’t believe me.
photo credit: Alice Chaos
- Make Sense of Your Hospital Bill – Consumer Reports Health
- Killer Billing Errors – The Washington Post
7 Comments to “Avoid Costly Medical Bill Errors & Mistakes”
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May 19th, 2009 at 4:48 am
Is there a statue of limitations-type rule for discovering medical bill errors?
May 19th, 2009 at 5:20 am
hmm good question, I’m not entirely sure. obviously disputing a mistake as early as possible (before you pay) will make things a lot easier than disputing a bill you’ve already paid and then having to seek a refund on the mistake. if someone knows the answer to jim’s question, please feel free to chime in.
May 20th, 2009 at 12:56 pm
I call this FRAUD, charging some one for something they never received. Considering 80% of the bills have errors and it is almost always tweaked to there favor. When i had my son I was charged for some medications, not really sure what they could have been because i took nothing, when I called the billing department they said “oh, we will take that off”. 600 dollars worth, what a rip off, and we wonder why are health care costs so much! The sad part is when you do have medications or procedures they make it so difficult to read and decipher how would you know if you did receive the medications or not?
May 25th, 2009 at 9:01 am
There is a two-year “timely filing” limitation with all insurance companies. It means that if they do not receive the itemized charges from the medical provider within two years they are no longer required to process or reimburse the claim.
In my experience I would have to agree with the 80% error statistic. When my mother was in the hospital a few years ago, my wife and I helped sort the mountain of medical bills for my father.
His employer made errors by changing plans in the middle of the year and reset their annual deductibles. Many claims were sent to the wrong insurance even though the latest insurance card was presented. The insurance paid in-network claims out of network. Medical providers attempted to bill for their write-off amounts. We even had the hospital force my father to pay for the deductible up front. Of course the hospital charges did not get processed first so there was no deductible on their claims.
We estimated that we saved my father over $10,000 in incorrect processed claims and inappropriate charges from medical providers.
Most people do not understand how all of this works and just make the payment requested by the medical providers bill. At minimum you must compare the bill to the Explanation of Benefits from the insurance company. First that will ensure the insurance has received and processed the bill. Second it will show how much the provider can charge you!
The number one error that I see is providers attempting to bill for the entire original amount without deducting their contracted write off amount!
September 3rd, 2009 at 12:42 pm
And it boggles my mind to hear Americans justifying the existing health care system… Hmm, Americans pay more $ for less health care than Canadians and it’s a good thing? Oh yeah I forgot – it’s a good thing if you’re working for an HMO or something like that. That’s billions in overhead.
November 6th, 2009 at 1:24 am
Nothing like bringing home baby Jenny and getting a bill for her circumcision..
January 2nd, 2010 at 6:20 pm
Do I have to pay a hospital bill if they took two years to send it to us? They also want to tack on $1500 for the nontimely payment! No kidding! Help!