Price Gouging: Real Life Instances

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In a recent article entitled “Are We Getting Gouged on Health Care Costs?” numerous instances of price gouging are described within the healthcare field along with data to support the research and findings. The title of the article was designed to catch the reader’s attention.

Is there still a question of whether or not we are being price gouged by the healthcare industry? Is there anyone in this country who has not felt the pinch of healthcare becoming one of the most profitable – if not the most profitable – businesses in the land?

medical_billing_advocate-67We see so many instances of unfair, unreasonable and inaccurate hospital bill charges, that it is now expected when we review a client’s bill. It is unclear of a time or an instance in which a hospital bill review contained completely accurate and fair charges.

The statement in which 80% of hospital bills contain errors, is exceedingly lenient. The true number is much closer to 100%, and it seems that as time progresses, that small percentage gap nearly vanishes.

Have you heard about the medical bill that nearly topped $1 million for the treatment of a snake bite? Medical Recovery Services reduced the entire bill to $86,000? While $86,000 is an astronomical amount that is enough to bankrupt many of us, consider the exorbitant amount this patient was overcharged.

A large number of individuals do not question their medical bills, putting trust in their healthcare providers. Once upon a time, that might have been an acceptable practice. Unfortunately, those days are far behind us.

The bill in which the patient was overcharged by nearly $900,000 went through several hands before it reached the patient. Many eyes saw that someone was being charged nearly $1 million for a simple anti-venom injection. Yet, no one questioned it. This could mean several things.

Either the employees in the billing department are not paying close attention to the charges on the bills that they are working on, or bills of this such are so commonplace that the employees are not phased when they see a bill of this amount for this type of service.

Regardless of what industry employs you, the staff in a billing department should take the appropriate action to a bill of such magnitude and review it to verify if the charge is correct and appropriate prior to billing the patient.

In turn, if a grocery clerk rings up a customer’s groceries and the total comes to $5,000, would this not be questioned if the number of groceries seemed too small an amount for the exorbitant cost? Hopefully, the customer is going to question the outrageously high amount and confirm that the clerk looks for any mistakes made.

In this type of scenario with a medical bill, a medical billing advocate can assist you. We make sure those over-charges are found and fixed before you pay the bill. In a perfect healthcare industry, a healthcare facility would charge a Fair and Reasonable amount and would double-check for duplicate charges, incorrect quantities and unbundled items prior to sending you the bill.

Unfortunately, we do not have such a healthcare industry. Medical billing advocates are greatly needed and will help to ensure that you are not paying a penny more than what you rightfully owe.

Filed under: Resources, US Healthcare, Obamacare, Medical Debt, Consumer Section, Hospital Bill Review, Affordable Care Act

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7 responses to “Price Gouging: Real Life Instances”

  1. Arryn Groom says:

    Hospital’s ER pricing is price gouging. This is a letter to my local hospital about my 4 hours ER visit resulting in a $12,000+ bill!

    … Regional Hospital
    Business Office
    St. Louis, MO
    Cc: Blue Cross Blue Shield of Illinois, … Chief Executive Officer …, Chief Financial Officer …
    Oct. 9, 2015
    Dear Business Administrators of … Regional Hospital,
    I am writing to you asking for consideration to modify your billing practices so that your rates reflect your actual costs are not such a financial blow to the average household. I understand that these billing practices have been in place for many years and those insurance companies have in large part set the rates, holding us all hostages to their policies. Whatever the case, the reality is inflated charges which bury the average patient with impossible charges.
    I went to the ER … July 5th with abdominal and leg pain, worried it could be a clot, appendicitis or kidney infection. I spent 4 hours which included a CT scan, blood draw, urinalysis and antibiotic IV drip. The bill I received was for $12,421. I’ve researched the hospital’s probable REAL cost and came up with approximately $2000 MAXIMUM. The hospital has been paid $6,828 by my insurance (which is in itself a mortgage payment at $900+/month for our family of 6 to have catastrophic insurance).
    Now … Regional Hospital wants me to pay IN FULL $5,567 MORE. Now. Really? Who can do this? Can you? How is this inflated billing even legal? How can any of you, in good conscience, send out bills like this which could mean financial ruin to most people, knowing the bill does not even come close to representing your true cost? At this rate NO ONE will be able to use our excellent emergency room system. I know I’ll have to feel like I’m dying if I ever go again, which will most likely mean I COULD. No wonder people panic when they think about going to the ER. That is unless they are on Medicaid and it’s all paid for by the government (ie us).
    I have a family, a mortgage, kids in school and financial obligations, like 99% of my fellow citizens. There is no way I can pay $5,567 IN FULL now. How can anyone? How can you even ask me to after you’ve already received $6,828 for $2000 worth of services?
    How has our honest American Healthcare come to this sordid practice? How many households have gone bankrupt because of these kinds of billing practices? Thank God I’m not chronically ill and Lord have mercy on those who are. No wonder people lose their houses to pay for their chronically ill family members.
    Please reconsider my bill and the bills of all those others who have been overcharged so egregiously.
    Thank you, …

  2. Terry says:

    Pat,
    I am a retired government employee with Cigna insurance.
    I have sleep apnea and use Apria Healthcare as a CPAP supply provider.
    Apria uses a company called Carecentrix as a biller or liason between Apria and Cigna.
    My question is about their billing practices.
    Example;
    3 pkgs of filters that Apria sells for $4.60 per pkg are billed to Cigna by Carecentrix for $53.25.
    3 cushions that Apria sells for $40 each are billed to Cigna by Carecentrix for $253.
    1 headgear that Apria sells for $20 each are billed to Cigna by Carecentrix for $37.90.
    If this is common practice, it seems to me that the amounts that Catecentrix is billing to insurance companies is quite high. Is this legal?
    Can you help me get this question to the right person or agency?
    Thanks,
    Terry

  3. Terry Evans says:

    Pat,
    I don’t mind paying it if it’s fair and legal. Just seems like they shouldn’t be able to mark things up so high and make the insurance companies pay them. Doesn’t seem fair.

  4. […] The truth is we wouldn’t need insurance for 90% of normal medical issues if the hospitals weren’t  price gouging. billadvocates.com/price-gouging-real-life-instances/ […]

  5. cheryl says:

    What happens when your told you have to take medicine for the rest of your life-with no insurance, and they{the medical professional] did’nt offer any options. After I got over the shock. I became angry refuse to live in fear!!! Made me think if you can’t afford you die no concern to them. What has happen to the oath medical
    doctors have taken or has that changed too?

    • says:

      Hi, Cheryl. Prescription drug costs are a huge factor in healthcare costs and something must be done to help protect patients from price gouging in that area. Have you talked to your doctor about assistance in paying for the medication? Many times, the doctor can give samples or coupons to help cover the costs. He or she might also be able to point you in the right direction for assistance based on diagnosis. I don’t know what your diagnosis is, but sometimes there is funding available through different organizations to help patients.

      I hope this information is helpful. Please don’t hesitate to give us a call at 855-203-7058.

  6. jason says:

    Even the Dentist’s are overcharging. Last week I went in for a normal cleaning to include of course 4 wing bite xrays. My insurance company was billed for over 600 dollars. I called my insurance company to find out the chargers that were on my bill that they didn’t cover to find out the codes. I called the Dentist office and they told me, they bill my insurance company and if the insurance company doesn’t pay they waive it. I was like WHAT? For example Code D0274 covers 4 wing bite xrays but the insurance company added 5 chargers of Code D0230 which are interal xrays they call it. I told the lady I only did 4 wing bites. So they billed my company hoping they would pay those extra 5 charges and if not they would waive it. WTF? The normal person wouldn’t even look at the charges so if my insurance company would of paid it they would of gotten away with it. There were other charges they did the same with too. Somebody has to figure away to put a stop to all this gouging in the Medical/Dental field. It is driving insurance prices so high that people can’t afford it anymore.