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a substantial amount of money there are a few things you can do
to substantially reduce your bills. With a little perseverance
and investment of time, you can uncover costly overcharging
errors you're not responsible for. After you're done, you can
negotiate what you legitimately owe and the payment terms.
Here's what to do:
Request both the hospital and your insurance company to audit
the hospital and doctor bills.
Demand an itemized bill (you are legally entitled to an itemized
bill if you request one) and review your self for the following:
Duplicate Billing: Make sure you haven't been charged twice for
the same service, supplies or medications.
Number of Days in the Hospital: Check the dates of your
admission and discharge. Most hospitals will charge for your
admission day, but not for your day of discharge. If you have
been charged for the day of discharge, ask the hospital to waive
the charge for that day.
Incorrect Room Charges: If you were in a semi-private room, make
sure you're not being charged for a private room.
Operating Room: It's not uncommon for hospitals to bill for more
operating room time than you actually used. Compare the charge
with your anesthesiologist's records.
Unbundled Charges: This is when a group of tests are billed
individually, when they should have been billed together.
Surgical procedures and tests frequently consist of several
parts. For instance, you could have received a cervical MRI and
a lumbar MRI. A hospital or MRI facility can bill $1,200 for
each MRI if they were done at different times, however, if they
were performed on the same day the total amount that the
facility will be paid by an insurance company may be only $1,400
or $1,800 instead of $2,400. Many times, MRI's will be scheduled
on different days, frequently one day after the other, in order
to bill at the higher rate. Do not allow a hospital or MRI
facility to charge you the full price if they did this. An
example of a procedure could be where you fractured two fingers
or two ribs and you were charged the full price to set each
finger or rib individually, instead of the full price to set one
finger or rib and a discounted price for the second finger or
rib.
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Up Selling: This occurs when a doctor orders a generic drug
which is readily available, but the hospital provides you with a
more costly brand name drug without your knowledge or consent
and bills you for the more costly medication. Since you are not
an expert at determining whether or not a drug use generic and
you may not have even been in a mental condition to make that
determination; your doctor ordered the generic drug; and it was
readily available in the hospital drug store, you are not
responsible for the increased charge.
Fraudulent Coding Also Called Up Coding: Hospitals may change
the charge for a lower cost service or medication to one that's
more costly. For instance, a doctor may order a generic drug,
but the hospital "accidentally" bills the patient for a much
more expensive brand name drug when the generic is actually
provided. If done intentionally, this is fraud. Where this
occurs several times on one bill or occurs with multiple
patients, this could constitute intent.
Fraudulent Coding/Weird Charges/Fake Language: Hospitals may
invent confusing language to cheat patients. They use medical
sounding names for everyday items and charge you an astronomical
price. For example, an "oral administration fee" is really a
charge for the nurse handing you pills. You do not have to pay
for that because it is part of the room and board. Other items
that have been reported as appearing on hospital bills are:
"disposable mucous recovery systems" (a box of Kleenex tissues);
"Thermal therapy" (a plastic bag filled with ice); "Gauze
collection bag" (a trash bag); and finally, a patient who was
given a teddy bear by the hospital and charged for a "cough
support device." Not only is this fraud, but if it wasn't
requested, the teddy bear was a gift.
Keystroke Error: A computer operator accidentally hits the wrong
key on a keyboard which can result in an incorrect charge or a
charge for a service you didn't get.
Canceled Services: You may have been charged for expensive
services or tests which your physician ordered and then canceled
or for some reason was never rendered.
Assignment: Check to see if the hospital or doctor accepts
assignment of your insurance payment. This means that the
hospital or doctor is allowed to bill your medical insurance and
to receive payment directly by your insurance company, without a
check going to you. This is a good thing. You can find out if
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the medical provider accepts assignment by asking your insurance
company. When a hospital or doctor accepts an assignment, you
are assigning to the hospital or doctor, your right to the
reimbursement check from your insurance company. By accepting
assignment, the medical provider is now in your position and has
whatever legal rights you had to collect the payment, and no
more. When accepting assignment, a hospital or doctor may not
legally seek any payment from you. This means that if the
medical provider bills your insurance company for $3,682 and you
were only entitled to be reimbursed $1,136, the medical provider
must accept this amount and you are not responsible for the
remainder of the bill.
Why do hospitals and doctors accept assignment? Because when the
check goes to the patient, many patients keep the money which
requires the hospital or doctor to sue the patient. Accepting
assignment allows the medical provider to know that they will be
paid and to avoid the costs of litigation if the medical
provider must sue the patient to recover payment for services
rendered.
Negotiating: Finally, after eliminating all of the errors you
can find, try negotiating your bill. If you are able to pay a
lump sum settlement to the hospital, you can usually negotiate
the amount you owe. You should be able to deduct at from one
third to one half of the bill, which is probably the amount that
the hospital would have to pay a lawyer to collect a fee from
you. Keep in mind, that collection agencies routinely settle
bills for 50%. Depending upon your income, you may even be able
to settle for as little as 10%. If you are unable to pay a lump
sum settlement, you should be able to negotiate a payout over a
period of years. If you do not earn much money, you can remind
your medical provider that if they obtain a judgment against
you, the court may award as little as $25 per month, even if the
bill is thousands of dollars.
About the author:
Philip L. Franckel, Esq., is the founder of HURT911®
href="http://www.HURT911.org">Accident Lawyer Directory for
people hurt in an accident. Mr. Franckel also publishes
href="http://www.Lawyer-Advertising-Blog.com">articles on Lawyer
Advertising and does
href="http://www.HURT911.org/getclient.php">advertising for
lawyers
Philip L. Franckel, Esq.Lower Your Medical Bills By Finding Medical & Hospital Bill Errors
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