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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Pat Palmer
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The MBAA team is dedicated to providing quality education for public and professional use, as well as top notch corporate training. If you would like to speak about a medical bill audit, we can help with that as well. Please fill out the form...

2 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.

    • Pat Palmer Pat Palmer says:

      Glad to see that you are proactive with your medical expenses! Everyone should always get detailed statements for any medical services and analyze them for accuracy prior to making arrangements to pay. Any time a provider participates with an insurance company, they’re required to file the total charges directly to the insurance company and should not bill until a response is received.

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