We all know that medical billing issues are considered a huge problem in America. Patient complaints continue to rise because of different and reasonable reasons. According to Nora Johnson, the former Director of Education and Hospital Billing Compliance for Medical Billing Advocates of America, “8 out of 10” hospital bills she inspects contain multiple errors. According to her, doctors’ offices and labs are more accurate and tend to have less mistakes, however, some patients are still left to pay for some unnecessary charges.
This is one of the reasons why patients want to avoid staying in hospitals as much as possible. They simply do not have enough trust in the hospital billing system and their physician.
Hospitals are using new devices that can contribute to either improving the current system, or committing more billing errors. If not properly set up, new devices can charge double for procedures and sometimes charge patients with surgical procedures doctors have not performed on them. These errors are often left unnoticed because hospitals rarely provide an itemized statement. Insurance companies themselves do not require itemized statements unless the bill equals more than $10,000. This leaves patients without the knowledge of what makes up the miscellaneous fees they are charged for, and end up paying for it, or expecting their health insurance to do so.
Below is one of the most common scenarios of medical billing error. This error is caused by new electronic devices being used.
A patient admitted himself because of severe pain due to appendicitis, and the doctor requires him to undergo appendectomy. The patient agreed to go through the surgical procedure. After the surgery, the physician advised the patient to stay in the hospital for a couple of days or weeks depending on the post-surgical condition.
A week after the procedure, the patient received his medical bill, and to his surprise, he was been charged of: several medication that was not given to him, a resident doctor that he did not even encounter, and an additional surgical procedure (laparoscopy) that did not happen. He was billed a total of $24,500. The client filed a complaint to the billing section of the hospital since he knew his right as a patient and because of the fact that those things were not given and performed to him and asked for a billing audit.
Ideally, the patient’s bill must only cost $15,830. The balance billed is a good example of a medical billing error. The client insisted his rights and gave the hospital relevant documents that will prove that he only had an appendectomy procedure, one attending physician, and only received few antibiotics. Fortunately, the hospital made an apology to the client and told him that their billing system is new and that certain mishaps are unavoidable because of the number of patients admitted in the hospital. At most, all they can do is promise to update the error and conduct additional studies on the bugs in their system.
Because of extremely high medical expenses, patients obviously do not want to experience medical billing errors. That’s why some people have even gone through the process of making a checklist of all the procedures and medications received from the hospital. They also review their bills from time to time to see if there are errors.
While it’s not everyone’s habit to constantly check on hospital bills and documents, we should be observant when it comes to hospital-related financial issues to avoid stress and frustration. We should know what to do when encountering errors like this since eventually, it will waste not only your money but also your precious time.
Even having health insurance does not mean you’re safe from paying medical expenses yourself. According to a survey by the Employee Benefit Research institute, 6 out of 10 Americans with health insurance are paying their medical expenses out of their pockets, because insurance is not enough.
Overcharged hospital bills are now a reality in America. It continues to grow because some public and private hospitals are unable to do anything to correct it. It is up to you to be aware, and learn what you can do to keep it at a minimum.
* This article was updated on September 23, 2016 to indicate that Norah Johnson no longer works for Medical Billing Advocates of America.