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How To Review A Hospital Bill And What To Do If You Find An Error

When I Look At A Hospital Bill, Where Do I Start?

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If you have kept a daily hospital log, compare it to the itemized bill. It will assist you in detecting charges for tests, physician visits and medication services that you did not receive.

Following is a list of the most common errors to look for:

  • The dates you were hospitalized, including days spent in special units such as the intensive care unit.
  • The charges for time spent in the operating and recovery rooms.
  • Obvious goofs such as two or more casts for one broken arm.
  • Duplicate billing. This often happens with minor items and un-requested items. Check the description for each item on the bill Something could be given different descriptions and then billed more than once.
  • Look for un-requested or unauthorized charges.
  • Charges for services that were not provided and items that were not delivered.
  • Confirm that the charges are the same for similar tests.
  • Watch for "bundled charges." Bundled charges known as DRGs (Diagnosis-related groups) are used increasingly by hospitals (and are required by Medicare.) Often a treatment will involve only a few of the components of a procedure. The billing department may assume you had every component.
  • Detecting overcharges for medication can be difficult, but look for medication charges that increase dramatically in a single day.
  • Check charges that are described with very general terms like "nutrition" or "anesthesiology." All general terms like this require further investigation.
  • Too many "miscellaneous" charges may indicate a billing problem that needs further investigation.
  • If you had surgery, check for services that weren't provided. You may have needed less than the "standard."
  • You should be charged for the type of room you requested, even if you ended up in a different kind of room. If you were in a room for two, you should be charged for a room for two, even if there was no other patient in the room. Or if you were put in a private room because no semi-private room was available when you entered the hospital, you should be billed for the semi-private room you requested. The lack of room availability is not what should determine your billing.
  • Question billing for duplicate items.
  • Duplicate testing may have been medically necessary, but it could also arise from the doctors' failure to coordinate their work. Paying for redundant testing should not be your responsibility.
  • For other charges, was it because the second charge was to repeat a service that was not correctly performed the first time? You shouldn't be billed for fixing an error.
  • If you receive an Explanation of Benefits (EOB) from an insurer, compare it with the hospital bill.
  • Don't pay for the discharge day if possible. Being discharged early in the morning, for example, does not justify you being billed for your last "day" in the hospital.

Also look for charges for treatment for medical errors or preventable conditions. For instance, a preventable condition is Stage 3 or 4 bed sores (medically known as "Pressure ulcers"). In fact, you may even be able to recover money for your damages due to such actions or inactions. If you have a question, consult a lawyer.

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