How to Know Your Bill is Accurate
Most people assume that the bill they receive from their hospital is accurate. Chances are, it is not. When you receive a medical bill, you want to make sure it contains ‘fair and reasonable’ prices and ‘true and accurate’ charges. With eight out of ten medical bills containing mistakes, it pays to get a medical bill audit. Medical bills typically contain errors and even bloated charges, resulting in numerous overcharges.
Types of Mistakes to Look For:
- Numerous errors are being caught when bills are examined by experts like medical billing advocates. Medical bills frequently have typos in the billing codes causing the patient to be charged for the wrong procedure or multiple procedures. While typos are an honest mistake, many other errors caught in medical bills are not.
- Medical facilities have been known to bloat their fees by using unbundled billing codes. When certain procedures are performed, there is a bundled code that can be used which covers the cost of multiple aspects of the procedure. However, increasing the cost, facilities might charge these items individually rather than in the group discounted price. Catching errors such as these can save you a significant amount of money.
- Charging for more time than used is another common error found in medical bills. For instance, a facility might bill for more time than was actually used for the operating room for a surgery. A bill might charge for four hours of operating room time when the surgery only took 90 minutes. At an average of $60 to $200 charged to the patient per minute, finding a time error such as this can help tremendously.
- Price gouging is common when scrutinizing itemized medical bills. It isn’t unusual to find that a facility has billed up to four times the going rate for a procedure. You might find that one hospital will charge far higher fees for a procedure than another hospital. Many patients assume a standard fee is charged across the board for particular procedures, but standard fees are virtually non-existent. A facility’s cost might differ greatly from another, as does the percentage above cost that is calculated when determining pricing. When a medical bill audit reveals this information, a medical billing advocate can fight to get charges that are fair and reasonable.
- An audit will also find visits being charged with the wrong level of service, resulting in a higher fee. Emergency rooms have different levels of service, which are based on an emergency severity index. The five levels of triage care are in place to code the severity of the patient’s injury or illness based on patient acuity. A level five patient requires the most urgent care while a level one patient’s injury or illness might not be urgent. Patients are sometimes billed for an emergency level they did not receive, such as a patient with a sprained ankle being billed for level five treatment.
Having a medical billing advocate on your side would be wise even if you do not suspect errors on your medical bills. You will be surprised at the types of errors that are uncovered by these knowledgeable auditors. A medical billing auditor will scour your bill looking for hidden charges and bloated fees that should not be on your bill.
