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Thursday, November 15, 2007

Hospital Overbilled You? Errors? Medical Claims Advocates Review Hospital Bills

At Medical Claims Advocates you can get ideas for action when there is an error on a medical bill. At CNN Money an article titled "Five Ways to Cut Your Medical Costs" by Cybele Weisser said that errors occur in 80% of medical bills. One of the suggestions the article made is to use a Medical Claims Advocate who can review your medical bills for a percentage of the money saved. A website at the Health Rights Hotline provides Independent Assistance for Health Care Consumers, and has suggestions for when medical billing problems occur or are suspected.

An acquaintance in his mid-seventies told me today about receiving a $600 bill from a hospital this week, for three procedures, with three different dates. He had been given treatments at a hospital after he fell while fishing in a river and cracked his knee. He said he understood the treatments involved an IV drip that lasted for about an hour, and were for the purpose of delivering antibiotics to the knee.

Here are the problems. He only had one of these types of treatments. He understood that his Secure Horizons would be paying for it. He was never near the hospital on two out of the three dates.

Luckily he did not automatically write out a check for $600 to pay the bill and mail it. This morning he went to the hospital business office. After spending the morning there, it was determined that he was correct. He was really only there for the treatments once. There were no other treatments scheduled or expected.

The amounts on the bill for two more treatments could have been a typing error, if someone hit a three instead of a one, but there are two more dates with treatments listed, so a typing error does not seem likely.

The hospital determined that Secure Horizons would now be billed and that he does not personally owe anything.

If he had not scrutinized his bill and gone to the hospital billing office to wait in line, and be an advocate for himself, he would have simply written out a check for $600.

How many other people out there are paying bills that have errors like this? If the hospital actually typed in two more dates and treatments, so this is not just a typing error, what is going on? What can be done to protect seniors from paying bills with errors, or something worse (were the two extra dates typed on purpose?), like this?

I searched on the internet and found the Medical Claims Advocate site. In addition to scrutinizing all of your bills carefully, keeping dates of your treatments to compare to the bills, and going back to ask for explanations, a Medical Claims Advocate can help "screen" the bills for errors.

It's another lesson to be careful before paying medical bills.

3 comments:

Anonymous said...

Besides the group you mention, there is also the Alliance of Claims Assistance Professionals, who do more than audit bills. We are a varied group of individuals with enormous experience in insurance, elder care, health law, provider billing, auditing, and more. CHeck us out at www.claims.org.

Catherine Nault, CAP
Charter Medical Mgmt & Consulting
Ph#: 520.661.9091
Fax#: 520.207.3022
Email: cnault@chartermedmgmt.com
www.chartermedmgmt.com
member of Alliance of Claims Assistance Professionals (www.claims.org)

Anonymous said...

Speaking of being overbilled, watch this youtube video that I saw. Watch the patient make sure that he'a getting his money's worth from the hospital

http://www.youtube.com/watch?v=KmGQ2WXPlSY

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