Decoding Your Medical Bill

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oldcoupleIf you have had a hospital stay or a medical procedure within the last decade, you know that the bill you receive tells you very little, giving you little chance of decoding your medical bill. You will see very clear information about the amount of money you owe, how to pay that money, and when it is due, but if you look closely at this bill, it doesn’t give much information about what exactly you are paying for. That’s because the bill that you receive from the hospital is usually just a summary bill. It will tell you very vaguely what you are paying for, but no real details. For example, the item description might state “Pharmacy” and tell you that you owe $589 for that portion of the bill. But what exactly are these pharmacy charges that they are billing you for?

If you are expected to pay a bill, of any kind, you should know exactly what you are paying for. If you were told you owe $362 when you took your vehicle for an oil change, wouldn’t you want to know exactly what these charges are for? Likewise, that “Pharmacy” charge should be broken down to tell you that you were charged $11.15 for each bag of 0.9% Sodium Chloride and that you were billed $19.05 for each dose of Promethazine.

Itemized Bill

Instead of paying blindly from a summary hospital bill, request a detailed, itemized bill. The facility must provide you with this if you request it. Most healthcare facilities will not automatically send you an itemized bill; you must ask for it.

Once you receive the itemized statement, you most likely won’t know what every line item means, unless you have a background in healthcare or healthcare billing. There will be a numerical code and an item description. The description might be shortened or might be a term you are unfamiliar with, but don’t worry. If you’re not sure of what an item is, you can contact the facility billing department and question it. Once you know what each item and service is, try to remember if you actually received it. It’s very common to be billed for something that your doctor had written an order for but was discontinued for a number of reasons.

Duplicate Charges

You will also want to look for duplicate charges. This can be done without a trained medical eye. Just look to see if you see the same charge on the bill more than once. If you know that you did not receive that item or service more than once, contact the billing department and alert them of the error. Request that the excess charge be removed and that an updated, corrected itemized bill be sent to you.

It is also common to have duplicate charges on your itemized bill that are camouflaged by other charges. The Operating Room is just one of the areas that is infamous for hiding duplicate charges in other charges. For instance, you might have been charged for a surgical kit and have separate charges for items used in your surgery. However, that kit might have those tools included in it, which means you were charged twice for the same items. But what you might not know is that these tools are necessary for performing that procedure; therefore, you will have paid for those items when you pay the charge for the procedure. In this instance, you could have been charged three times for the same items.

If this sounds overwhelming, you’re not alone. Millions of Americans have difficulty deciphering their medical bills. Unfortunately, many Americans do not know that medical billing advocates are available to help them navigate through the labyrinth of medical jargon, codes, and hidden charges. If you would like help evaluating your medical bills, call Medical Billing Advocates of America at 855-203-7058.


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