Hospital Bill Audit Services

How to Obtain a Hospital Bill Audit

A hospital bill audit will save a patient thousands of dollars, more often than not. The reason is, far more than half of all medical bills contain errors, according to two recent studies on medical bills. This makes it necessary for the patient to seek out an audit before paying their hospital bills.

Many medical billing specialist companies will offer the service of a hospital bill audit. They have specialized software that will scrub the bills to find billing codes errors and gross overcharges for items and services. The specialist will then hand check those billing mistakes to see if the data is accurate, then approach the hospital to have the bill corrected.

Types of Medical Billing Errors Found

The types of errors that a medical billing specialist will find in the hospital bill audit are up coding, duplicate charges, non-billable items, level of service errors and other overcharges. All of these errors can cost the patient thousands of dollars in extra charges.

Up coding is a common error found in a hospital bill audit. This is when the hospital will use a medical billing code that doesn’t match the type of procedure that was given. A medical procedure will have a range of billing codes with each describing the type of procedure that was done. Sometimes the procedure will be a routine procedure and for more severe injuries the procedure might be very complex. There are times when a patient will have a simple, routine procedure and be billed for the more costly, complex procedure.

Level of service charge errors are also caught in a hospital bill audit. For instance, a trip to the emergency room for a sprained ankle might result in being charged for a level of the emergency room that is used for lifesaving procedures. This will add a hefty cost to the hospital bill.

Overcharges will also be caught in the hospital bill audit because the medical billing specialist company keeps track of what the standard fees for procedures are in various cities. This enables the auditor to catch patient price gouging on procedure fees and overcharges for items in the hospital.

Upselling is when the hospital will make substitutions that will result in higher costs for the patient. For example, the doctor will prescribe a generic medication and the hospital will send a name brand that is far more expensive than the generic. This is done to inflate the patient’s bill, not because they didn’t have the generic on hand.
The hospital bill audit will include reviewing the medical records and comparing it to the patient’s bill to find errors. It is here that many overcharges can be found from level of service errors, upselling, and non-billable items to duplicate charges.

A Hospital Bill Audit Can Save Thousands

A patient can likely save thousands of dollars by enlisting the help of a medical billing specialist to do a hospital bill audit. With 80% of medical bills containing errors and overcharges these days, it really pays off to have the audit done on all medical bills before paying them.