Tuesday, September 28, 2010

Do you Check Your Medical Bill?

Many people don’t bother to read the charges in their medical and/or hospital bills. This can be a very costly mistake, particularly when you expect your insurance or Medicare to be covering the costs and they don’t. Recently, Jane Brody, of the New York Times wrote about this in Put Your Hospital Bills Under a Microscope.

According to Medical Billing Advocates of America, a group that checks bills for consumers, 8 out 10 hospital bills it scrutinizes contain multiple errors. Keeping a health log of visits, medications and treatments received (see Managing Health Information on-line ) as well as reviewing bills as you receive them, can go along way to help reduce errors. The following tips on what to look for come from Consumer Reports Health.

Incorrect basic data: If information such as your name or your insurer's group number is wrong, the amount the plan covered is likely to be off, too.

Duplicate orders for medications, lab work, or room fees: For example, a hospital might bill a patient for a procedure even though a doctor canceled it, or you might get a bill for 11 cholesterol tests instead of one.

Unbundled fees: If you were charged for several lab tests in one day, call your insurer to see whether the charges should have been bundled under one fee. And look for the words kit, tray, and room fees. Each of those charges should cover many items; operating room fees, for example, should include sheets, gowns, and gloves. Call your insurer to see what's included so you can be sure you didn't receive any duplicate charges.

Operating-room times: If you had surgery, your anesthesia record will state when your surgery began and ended. That gives you a way to check for appropriate costs. Operating-room use is generally billed at rates that vary from $69 to $270 per minute. You might find, for example, that you were billed 240 minutes for a procedure that took only 180 minutes.

Up-selling: : It occurs when you have a stay in the hospital and your doctor orders a generic drug, but the hospital provides you with a more costly brand-name version. Because you are not an expert at determining whether a drug is generic, you are not responsible for the increased charge.

Fraud Guides has also compiled a list of the most common medical billing errors and what you can do to protect yourself:
• Repeat billing: ensure you haven't been charged twice for the same procedure, supplies or medications.

• Length of stay: Double-check the dates of your admission and discharge. Were you charged for the day you checked out? Most hospitals will charge for the day you arrived, but not for day you left.

• Correct charge for type of room: If you were in a shared room, confirm you're not being charged for a private one.

• Time in OR: Sometimes hospitals charge based on an "average" time needed to perform an operation. Contrast the charge you received against your anesthesiologist's records.

• Up coding: Happens when a doctor changes an order for medication and/or service from an expensive version to one that costs less, like generic medications. And yet you're billed at the higher rate. And sometimes you're billed for both. Keep on top of this one; it's the most widespread of all the common billing errors.

• Keystroke mistake: Happens to the best of us, an innocent slip up on the keyboard that can result in significant overcharges or in some cases an undercharge.

• Canceled service: Occasionally a medication, procedure or service that was prearranged and then canceled later will still show up on your final invoice
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If you find a mistake, call the billing office and go over it. It may take some persistence, but the more proof you have going into it, the better off you’ll be.

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