Hospitals screw up billing all the time and have you ever noticed it’s never in your favor? Nora Johnson, a medical-billing auditor, claims that “More than 90 percent of the bills I review are either wrong or padded beyond belief.” She even said that her own husband was “once charged for blood tests for a newborn as part of his hip-replacement surgery.”
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1. Review The Bill, Know The Codes
There are two kinds of codes on that medical bill, a diagnostic code, and procedural code. The diagnostic codes are ICD-9 codes that diagnose the problem, i.e. figure out what’s wrong. The procedural codes are CPT codes that provide the treatment, i.e. make you feel better. As you can imagine, anything from fraud to a typo could result in higher charges. Ask for a thorough explanation from the hospital or doctor.
2. Be prepared
When your doctor prescribes something, it’s recorded in their standing orders and you have a right to it. So when you’re done with the visit, be sure to request those orders from the billing office and keep them in your own files. The article also recommends getting these documents as well:
- Reports by any technician handling a procedure, as well as the nurses who administer medication or shuttle you around in your paper gown
- Itemized bills (request these from your doctors or hospital, possibly after your treatment visit)
- Your insurance paperwork
- Your own notes from each doctor visit
3. Use certified mail
When you send letters to anywhere, use certified mail. Use it to request a corrected bill and use it to describe the problem to your insurer. Get as much documentation as possible because your claim will depend on that. It creates that paper trail that you’ll need if it ever gets real ugly.
4. Check for Billing Errors
Ever go to the grocery store and get double-billed on a box of macaroni and cheese? How about seeing an appetizer you never enjoyed on your restaurant bill? Those are like three-dollar mistakes if you ever miss them. Now imagine if you missed a three hundred dollar procedure on a hospital bill (which are ridiculously obfuscated with codes and acronyms and written in some sort of alien shorthand), that’s a lot of missed appetizers and boxes of mac and cheese. Medical billing errors happen and they’re the subject of the fourth tip in CNN Money’s Fifty Ways To Cut Your Health-Care Costs.
They estimate that as many as 80% of hospital bills have errors and that amounts to a 25% increase, on average, in how much they’re charging. Personally, I think this is absolutely ludicrous considering they have computers but when you consider nurses work in shifts of twelve hours plus, three days straight (I don’t know the typical hours of anyone else in the medical profession, but I bet it’s ridiculous) it’s not surprising to see key-in errors (especially if they have to convert from English into alien shorthand). So, they recommend that you keep a log of every test and medication you get and check it against your file, which can be ordered from the billing office. Request fixes via certified letter and make copies of everything.
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Negotiating With Your Doctor
You may be surprised to hear that often, the rates doctors charge are not absolute. They often have the discretion to change their rates. They are, of course, a business and just like any other business they may be willing to negotiate. Where this makes the most sense is when you have a high deductible or have no insurance whatsoever and are paying out of your own pocket. In those situations, you can probably explain to your doctor and they’ll usually be sympathetic.
Here an interesting statistic:
According to a 2005 Harris Interactive poll, about two-thirds of adults who negotiated for lower prices with a hospital or dentist succeeded, as did three out of five adults who bargained with their doctor.
Know Their Costs
Request the costs for some common medical procedures so that you have more ammunition when you go to bargain with your doctor. Shopping for health care is like shopping for groceries, you should have a general idea of how much a gallon of milk costs so that when you see it on sale for $10, you don’t get suckered in by the “sale.” The difficulty with medical costs is that it usually happens when you’re not well and you, hopefully, don’t buy much health care so you aren’t aware of how much a procedure should cost.
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