Why You Need a Hospital Bill Review

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Most people don’t realize that eight out of ten hospital bills contain mistakes.  These mistakes could cause you to pay thousands of dollars more than you should. Most everyone will benefit by having a specialist perform a hospital bill review to take a close look at what you were charged for your hospital stay.

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Erroneous Hospital Charges

Once you have a detailed itemized statement from the hospital, you can see exactly what items you were charged. Hospitals do not automatically give this detailed information to patients; it is something you need to request.  A review of this detailed hospital bill might uncover charges for procedures or services you did not receive, incorrect billing codes, unfair or unreasonable prices, or incorrect levels of service.

Being charged for the wrong level of service can be revealed with a hospital bill review.   An emergency room will charge according to the emergency severity level. If you are not in need of equipment for treating severe injuries or symptoms, the charge should be lower. If your injury or illness   is considered a higher severity level and requires life-saving equipment, the charge should be higher.

For example, if you are having a heart attack, you will pay for the services and equipment required to treat it. If you are in the emergency room for a minor cut, you should be charged much less because your injury should not require much – if any – special equipment.  Because of the various items for which you could be charged and different severity levels, it is important to make sure you are being billed properly.  This is not only an issue that comes up with the bill from the hospital, but also the bill that comes from the treating physician.

A hospital bill review will also discover charges for miscellaneous items such as blankets, gloves and lights, which should be included in the fee for the use of the room. Charging for these types of items is considered double billing because these charges should be included in the charge for “room and board”.

Many times a hospital bill review can alert you that you are being billed for medications or tests that were ordered but never received. Let’s say your physician ordered penicillin, but you never receive it because you let the medical staff know you are allergic to it.  However, the billing department saw it on your chart, and bill you for it.  The same can happen with medical tests. For whatever reason, the doctor changed his mind about giving you a medical test. Nevertheless, it was seen on your chart by the billing department and you were billed for it although you never received the test.

 

Only Pay what’s Fair

Hospitals are notorious for over-billing and most people just assume it is correct, but it usually is not. Most of the time, a hospital bill review will show a lot of charges that are double billings, erroneous billings, billing code mistakes and even exorbitant charges for simple items like aspirin. You have the right to pay only ”true and accurate” and “fair and reasonable” charges for your hospital stay.

Filed under: Resources, MBAA Education Center, Hospital Bill Review

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7 responses to “Why You Need a Hospital Bill Review”

  1. Shelley says:

    Interesting. because I always call the hospital/ insurance company when I receive a bill to check and query the amount. The amount has not been sent in as a claim or it is incorrect.

  2. Linda McLean says:

    Was in the hospital June 2-7 of this year. When I looked at my bill I noticed a charged for something I didn’t have. When I was finally able to reach someone by phone, she said it wasn’t on what she could see. I asked for an itemized bill. It was 2 weeks before I received it and there are thing I don’t understand. Was hoping there might be someone that could help me.

  3. […] Check the charges
 Before you do anything drastic, such as filing for bankruptcy or taking out a short-term loan to pay your medical bills off, make sure the charges on your bill are correct. You might be thinking that this is an impractical possibility, but mistakes are made all the time. In fact, the Medical Billing Advocates of America noted that 8 out of 10 hospital bills have mistakes. […]

  4. Mike Hughes says:

    I was seen in a emergency department. They at no time utilized the medical information in my wallet which identifies allergies and wouldn’t take my USB medical alert bracelet. They sent me a bill with the wrong name. The first name is my middle name which I utilize every day. But for billing and insurnace purpsoes it isn’t used.

    Thanks

  5. Daniel says:

    hospitals should NOT be handing out bills to people who go to the emergency room or for hospital stays. There’s got to be a way to stop this for once and for all. And I mean forever.

  6. joe says:

    Hi Pat,

    Is there an affordable service that reviews medical bills for accuracy?

  7. Pat says:

    My father was forced to pay for an ambulance to transfer him to a hospital close to home, a trip of about an hour and 15 minutes by car, when he was injured on vacation (over $5,000). Both Medicare and his insurance through his military service have paid out on the ambulance , but the hospital has been giving us a runaround for the past 5 months on reimbursing us for this exorbitant charge. I have an EOB showing that all charges for his emergency room care have been settled and that we owe nothing on it. The hospital’s representatives refer to another bill which they have never sent us, that they claim lists $22,000 outstanding on Dad’s emergency room care. If this money is outstanding, why haven’t they billed us, and how can they get away with applying Dad’s $5,000 to a bill they never presented us with?