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Summary

We all know that a stay in the hospital is expensive and many costs are out of your control. Remember what Groucho Marx said.  "A hospital bed is a parked taxi with the meter running."

However, there are things that you can do to save money. Click on the links for more information:

  • Talk with your doctor about the fee.
    • If you have insurance, ask your doctors if they would be willing to accept your insurance as payment in full.  Many doctors will be agreeable, particularly if the additional cost would cause you undue hardship.
  • Avoid unnecessary tests and procedures.
  • Keep a daily log.
  • Refuse to be seen by any doctor that you don't know.
    • Ask each doctor to identify him- or herself and explain what he is doing (the purpose for being in your room). After you know the doctor's identity and what the reason for the visit, you can make the decision whether to allow the doctor to proceed. Even if the doctor is only "dropping by to see how you are feeling," it is likely that you will be billed for a hospital visit.
    • We recently heard of a patient who woke up to find an unknown doctor and several medical students at his bedside. The doctor introduced himself, explained that he was on teaching rounds and asked if the patient felt well enough to be interviewed and examined as part of the student's medical training. Wanting to be helpful, the patient agreed. Later to his surprise, he received a doctor bill for $250. According to the patient, "I was shocked. I just thought I was being a nice guy. This doctor never even laid a hand or stethoscope on me."
  • If you have a managed care type of insurance, try to avoid doctors who are not in your network.
    • Tell your doctor that you have a managed care type of health insurance and only want to be seen by in-network medical personnel unless there is an overriding need for someone out of network. 
    • If you can't avoid non-network doctors and your insurer refuses to pay,appeal. You can argue that you had no choice. You were in the hospital and no in-network doctor was available. This argument has been known to work. 

How To Avoid Unnecessary Tests And Procedures In Hospital

TESTS

It is easy for doctors to order tests when you are in the hospital, and testing sometimes becomes excessive.  This is especially true if you are covered by insurance. 

To avoid unnecessary or duplicative testing, request prior approval of each and every test.  Make sure that this request is noted in your medical chart.

Speak to your doctor about avoiding tests that will not sacrifice the quality of your care.  To help determine if a test is necessary, you may wish to ask your doctor the following questions:

  • What is the purpose of the test?
  • What would happen if the test were postponed to see if my condition worsens?
  • Will the test be covered by my insurance?

If there are to be multiple blood tests, ask that one sample be used for all tests. It's not always possible, but the request should help.

Refuse to have blood drawn for any unexpected or unexplained tests.  Politely ask for an  explanation. You don't want to be known as a cranky patient unnecessarily.

If you are in doubt about the necessity of any test or procedure that is to be preformed tell your nurse that you want to speak to your doctor before submitting to the test or procedure.  Sometimes your doctor will order a test and/or procedure and forget to inform you. Sometimes your doctor doesn't know that some one else ordered it.  

PROCEDURES

Doctors and hospitals get paid more by Medicare and private insurers for doing something -- especially for cutting patients open or doing some kind of invasive diagnostic procedure -- than for treating them with drugs, or for simply watching and waiting.

How To Keep A Daily Log In Hospital

Keep a running log, or ask your advocate to keep one, of all the services that you receive.  This list should be as comprehensive as possible.  The log is important as a comparison when there is a review of your hospital bill.  The log should include the following:

  • The dates of admission and release from the hospital.
  • The exact number of hours spent in the hospital operating and recovery room.  At an average cost of $300-600 an hour, the charges add up quickly.
  • The dates you are in a specialized unit, such as intensive care or cardiac care unit.
  • All tests performed.
  • Any treatments administered.
  • All medications received.  You will be charged right down to the last aspirin. (And some hospitals have been known to charge as much as $12 per pill.)
  • All doctors' visits.  This should include name, specialty, and what they did.
  • All supplies used as part of a medical procedure or treatment.  This includes items such as gauze packs for wound dressings, disposable emesis basins, ice packs, or suture removal sets.
  • Any personal items.  This might include toothbrushes or toiletries. To save money, bring your own.  Because hospitals are under financial pressure and trying to control their bottom line, they are charging for every service, including many that used to be free.

You can ask for a daily itemization of your bill be brought to you each day while you are in the hospital.