Our Ask An Angel correspondent is Arlene Petersen, Certified Senior Advisor and Life Care Navigation Specialist in the area of senior home care.
Q. I was just released from the hospital, and I wonder if my bill is on the up and up. How do I make sure I didnât get overcharged for things, or even more, get billed for things I didnât use?
A. Hospital bills are difficult to decipher. Itâs almost as if there is another language out there that only doctors and hospital staff can read. Every procedure and item has a special code, so itâs no wonder we canât make much sense of our bills!
Health.com offers these steps to take to protect yourself against paying more than you should.
Talk to your hospital about the bill ahead of time. If youâre paying your own way for an expensive medical procedure, like a coronary bypass, go in advance and ask to speak to the chief financial officer of the hospital, advises Gerard F. Anderson, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. You might not reach that personâmore likely, you will be passed to a manager in the financial departmentâbut speak to the highest-level official you can. Hospitals, which usually charge three or four times the cost of their services, routinely accept discounted payments from insurers and Medicare, so they may be persuaded to give you a break too. âSay, âIâm willing to pay a little bit more than what Medicare pays.â Often they will give you a substantial discount â 30 percent or more,â Anderson said.
Keep a log. To the extent that youâre able, write down the dates of your hospital procedures and medicines that youâre given, so you have something to check the bill against later. âIf you have an accountant mentality and youâre awake enough to be able to do that, thatâs great, but the reality is that many people canât,â Louis Saccoccio, executive director of the National Health Care Anti-Fraud Association, said. If youâre too weak to do it yourself, assign a friend or family member to the task.
Double-check your personal information on file with the hospital and your insurer. An incorrect social security number, name, address, or date of birth can result in accidentally being charged for someone elseâs treatment. Also: âBe very careful of your insurance card. Make sure no one gets hold of it or makes copies of it unnecessarily. Someone could try to use it to get health-care services,â Saccoccio said. Victims of what is now termed medical identity theft have found their health-insurance lifetime limits exhausted after their accounts were billed for services they never received. The Federal Trade Commission measured statistics on medical identity theft for the first time in November 2007, finding approximately 250,000 victims in 2005. Health-care employees, not random thieves, are thought to be responsible for most stolen insurance numbers, but you can help protect yourself by guarding your insurance information closely. Since you will have to present your insurance card when you are admitted to the hospital or go to a doctor’s appointment, be vigilant about checking your bill and making sure it doesn’t include any fraudulent charges that may have stemmed from an inside job.
Order an itemized statement. Many hospitals send a summary of charges, but you have a right to ask for the complete breakdown. Look at the line charges and the diagnostic codes. These can be hard for the average person to understand, but if something looks fishy, ask the billing department to explain it. If you have a bill of $10,000 or more, however, consider hiring a professional bill auditor, Waxman advises.
Read your explanation of benefits (EOB). Your insurer will send you a letter that explains exactly what was paid and how much you are responsible for. Compare it with the hospital bill. Though the “medical-eseâ may be hard to understand, at least check the dates for accuracy. âIf you were in the hospital overnight, and a month later you get an EOB that says the hospital stay was four days, then obviously something is wrong,â Saccoccio said. If you kept a log during your stay, compare it against the services and medicines on your EOB. If there are discrepancies, ask your health plan to review your hospital bill.
Enlist help from the state. If you are held responsible for charges that you think are erroneous, contact the consumer protection office of the state attorney generalâs office for help. Visit the website of the National Association of Attorneys General to find the phone number for the attorney general’s office in your state.
Consider hiring help. Medical billing advocates charge an hourly fee (about $25) or take a percentage of recovered money to audit your medical bills and negotiate with health-care providers. If you have a very large set of confusing bills and think there may be errors, this can be a time-saving option. You can find a professional through Medical Billing Advocates of America, a network of 61 medical bill auditing companies across the country.
You can be proactive in other ways including calling the hospital billing department and asking them what you will be charged for the room and what those charges cover. For example, if tissues aren’t included, bring your own. It wouldnât hurt to ask your doctor about the cost of treatment as well. Ask your doctor if you can bring your prescriptions from home to avoid paying for medications at the hospital. Don’t accept bills that use terms like “lab fees” or “miscellaneous fees.” Ask for an itemized bill. If necessary, ask for copies of your medical records to see if you received the treatments you’ve been billed for.
Have a question for our angel correspondent? You can send our angel an email to apetersen@visitingangels.com or send your question via mail to Ask An Angel, 65 Woodbury St., South Elgin, IL 60177.
