Medical Bill Mistakes

Staring at your medical bills can be a headache, but you shouldn't simply pay them and file them away. According to the Medical Billing Advocates of America eight out of 10 hospital bills contain mistakes. Jody Rohlena, Senior Editor for ShopSmart Magazine, shares how to spot these errors and save money. 

First, take a look at your personal data. Make sure your name and address, as well as your insurer's group number, are correct. If they're wrong, chances are the amount your health plan covered is always incorrect.

Check dates and times. If you were in the hospital, see how many daily room-and-board charges are listed. It's standard procedure that hospitals should not charge you for your discharge day, although they sometimes do. If you had surgery, call your anesthesiologist and ask when the surgery began and when it ended. Operating-room charges can be as high as $300 per minute.

Look for duplicate or incorrect charges. It's important to check bills for drugs, lab work, and procedures. You might see charges for 11 X-rays instead of the one you had. And it's not uncommon to be billed for a procedure that your doctor canceled.

Hospitals often lump many charges together, or bundle them under one heading and a flat fee if all the procedures were done in one day. So if you had a checkup and were charged several fees for blood tests instead of one lower flat fee, call your insurer to see whether the charges should have been bundled. Also, if there are terms you don't understand, you might find that they should have been bundled with another charge. For example, an "oral administration fee" on a hospital bill is a charge for a nurse to hand you your pills and should be included in room and board.

Check and see if your diagnosis has been "upcoded." A patient's diagnosis code might be inflated to a more serious condition that requires more costly procedures. If a diagnosis or a treatment listed on your bill sound incorrect, call your doctor or other provider for an explanation.

If you do find an error some insurers will pay you a reward for spotting them. Each time you call to check on a bill, keep record of the date, time, and the name of the person you spoke with, and take notes. That might be all you have to do to get an error fixed. If not, call your insurer. If the matter is still not settled, contact your state insurance commissioner's office (find a link to states' offices at www.naic.org ).

If you can't get the problem resolved before the bill is due, pay any part of the bill that's not in dispute to protect your credit score. If things are not resolved within 60 days, check your credit reports. The unpaid amount might be reported to credit bureaus, and your credit score could get dinged. To check your credit reports for free, go to www.annualcreditreport.com. If you find the disputed bills on your reports as unpaid accounts, write to the credit bureaus to explain the dispute. The bureaus must review your complaint and correct your report.

For more information on correcting medical bill errors and other consumer topics, click here.Medical Bill Mistakes