Understanding Your Bill

Graphic sample hospital bill.
U.S. News & World Report
On roll the charges for eight pages. When his ordeal began, the 25-year-old man figured he just had a stubborn cold. His breathing grew labored. An ultrasound exam prompted doctors to thread a tube into an artery and snake it up to his heart to look around. The verdict: pericarditis—inflammation of the sac around the heart. Ultimately he needed open-heart surgery.

He could have used a translator later. The itemized surgery bill excerpted below includes no-brainers like "aspirin 325mg tab." But what about "telemetry-semi," and "lab-fungus smear"? And are all the charges correct? Did this man receive every service listed?

Ninety percent of hospital bills have errors of some kind, estimates Mary Jane Stull, president of the Patient's Advocate, a South Bend, Ind., firm paid by befuddled patients to intercede on their behalf. "But it's not always intentional," she says. "You find just as many mistakes for things they've forgotten to charge you for as you find overcharges."

From admission to discharge, Dr. Bernadine Healy preps patients and their families for major surgery
Line by line. You'll have to plod through to find out. Some hospitals are working on patient-friendlier bills, but yours will likely resemble this one. The billing office should be willing to explain puzzling entries. If not, and the stakes are high, you can obtain help, for a fee, from members of the Medical Billing Advocates of America.

If the total is unaffordable or far beyond what your health insurance will cover, the hospital may have a special program to help cover at least some of the charges. You should ask, if — as is possible — the hospital doesn't volunteer the information.

By Adam Voiland