Medical billing errors are rampant, and with changes to the healthcare system mandated by the Affordable Care Act, as well as a conversion in medical billing codes expected later this year — increasing the number of codes from some 13,000 to nearly 70,000 – the situation is likely to get even worse.
However, there are some simple steps you can take to protect yourself from being overcharged.
Prior to and during treatment
If you will be scheduling a medical procedure and have the benefit of time on your side, ask your physician, hospital and your insurance company to give you a detailed estimate of the costs you will incur. With this information obtained in advance, you can compare the estimated-to-actual expenses later.
You can also use free online tools like Best Hospitals to compare the costs of common procedure among your local hospitals.
During your treatment or hospital stay, have a friend or family member help you keep a written log noting the date and time of tests, prescriptions, physician visits, provided equipment and any other items that you think you may be charged for. This will arm you with additional information once the bill arrives.
When you get the bills
After your treatment, if you receive a summary invoice from the hospital, contact the billing department and request an itemized statement. A detailed bill will show equipment, tests, prescriptions and all services and items provided. Compare that to the “explanation of benefits” (EOB) statement you receive from your health insurance company.
When reviewing the charges, here are some of the particular items you will want to look for:
- Confirm the correct spelling of your name and the accuracy of other personal data, as well as your insurance policy information and hospital details.
- Verify that the correct procedure was billed.
- Watch for duplicate charges, including medications, lab work and diagnostics.
- Pay particular attention to charges that include the words “kit” or “tray.” These bundled items may also be billed separately, in effect charging you twice.
- Note if the correct room charges (semi-private or private) were billed for the right number of days.
- Operating room (OR) charges, usually billed by the minute, can be compared to anesthesia records, which will note the beginning and ending time of surgery. That will help you to determine if the proper OR time has been billed.
If you find errors
If you find medical billing errors, you can attempt to have them corrected on your own. You will want to contact your insurance company, the physician and hospital to make them aware of your concerns.
But if you are overwhelmed by the process and have difficulty interpreting and reconciling charges on your own, or are unsuccessful having billing issues fully addressed, you may want to consider contacting a medical billing advocate.
With experience in reading and reviewing medical charges, a medical billing advocate can assist you in getting mistakes and overcharges corrected. Some will charge an hourly fee while others will simply bill a percentage, typically ranging from 15-35%, of the costs they save you.
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Originally published on: Saludify.com
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