5/2/2014 3:45 PM ET|
5 hidden costs of hospital visits
Check your bill for these errors and irksome fees.
When Ritter Elizabeth Hoy, 33, went to an emergency room in Oxford, Ohio, last summer, she spent approximately six hours undergoing tests until she was sent home with some codeine for her pain and no diagnosis. The following day, very much in pain, Hoy found another hospital, where the physician took an X-ray – something the ER doctor didn’t do the day before – and concluded Hoy had two broken ribs.
"It was my own stupid fault," says Hoy, who had attempted to move a refrigerator on her own in her apartment.
Not long afterward, Hoy, a marketing professional, became sick again – this time, from her hospital bills. The first emergency room visit cost four times more than the second and didn’t even conclude that she had broken ribs.
"It's an absolute scam," says Hoy, who has come to hate hospital bills, never mind that her father worked 25 years as an ER doctor. In fact, two months after her broken ribs, she was spending time with a relative in Florida when she fainted and wound up in another hospital. She didn't stay overnight, but the bill was $10,000.
"I didn't care as much about that," Hoy admits. "By then, my deductible was paid."
Everyone knows hospital billing is out of control, but the bills often produce sticker shock because of hidden costs, charges patients have no idea are coming. Of course, rarely does someone know exactly how much an operation or hospital stay will cost at the outset. But even in the most predictable of situations, hospital costs vary greatly, and mistakes occur often. How often? According to Medical Billing Advocates of America, a national association that reviews medical bills for consumers, 80 percent of hospital bills contain errors.
In 2012, The Cleveland Plain Dealer ran a series of articles examining medical billing and found that at a typical hospital, as many as 289 people put information in your chart that will determine the final price on your bill, assuming you are having surgery and staying in the hospital for four days. That includes intake workers (who take your information), physicians, nurses, billing coders and "many others along the way," as the Plain Dealer noted.
Still, if you're aiming to manage your hospital-related costs before a procedure or you want to undo some of the financial damage after the bill comes, here's what you should look for.
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You may pity the administrator who has to explain this fee to a disgruntled patient. Facility fees, sometimes referred to as provider-based billing, can occur after a hospital buys a doctor's practice. If you get a medical test at a doctor's practice owned by a hospital, you may get charged a facility fee that can easily cost hundreds of dollars. And what are you paying for? The hospital's extra overhead. You probably won't be able to negotiate that after a procedure, but you may be able to avoid it if you discover this charge beforehand.
Sometimes doctors perform two or more procedures during the same surgery and bill you as if you went into surgery two or more times. There are also news reports of physicians coming into rooms and looking at a chart and then billing the patient for it – even when there's another doctor already overseeing and billing the patient. At some hospitals, you may be checked out by someone lower on the totem pole than the doctor, who is nevertheless around to supervise. So you get a bill from the certified registered nurse and the doctor. In many instances, this isn't supposed to happen, and while your insurer should catch these mistakes, you should also be on the lookout.
This is just what it sounds like – being billed for a service at a price higher than most hospitals charge. Most people don't have a good sense of what one should pay when they're sick, but you can get a better idea about how much medical procedures and physician services in your area cost on Fair Health's website, specifically its Consumer Cost Lookup tool.
Other health care services comparison sites include healthcarebluebook.com and clearhealthcosts.com.
Another possible overcharge is if you were charged for a brand name medicine when a generic was available. You might be able to argue with a hospital administrator that you shouldn't have to pay for a more expensive drug when you could have been prescribed a cheaper equivalent.
Patients will sometimes discover charges for rogue items like gloves, which should be included in the operating room fee. Or you might get billed for a toothbrush or comb, which should be included in the cost of your hospital room.
Fees involving time
If you're charged for the time you spent in your room on the day you were discharged, most insurance plans won't allow that. You might have some luck arguing that, like a hotel, a hospital shouldn't bill you for the several hours you spent there that morning. (Of course, the hotel analogy, with checkout times normally at 11 a.m. or noon, may not wash if you didn't leave the hospital until 2 p.m.)
And presumably accidentally, sometimes hospitals will bill you for more time than you actually spent in the operating room. So that's something you should keep an eye out for, in case you suspect it added an extra half-hour or so. It can make a real difference. Hospitals charge for operating rooms by the minute, not the hour.
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Small wonder that one in four American families struggled to pay medical bills in 2012, and 10 percent of Americans couldn't pay any of their medical bills, according to a survey released earlier this year by the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention. (The survey used 2012 data, collected from 43,345 families.)
So if you find hidden charges on a hospital bill, especially if it's after a procedure, surgery or hospital stay, can you negotiate the price down? The answer is a definite maybe, according to Robin Gelburd, president of Fair Health.
"It's a living laboratory we're in right now," Gelburd says. "We're in the process of dramatic changes in the health care industry."
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And that is a very good reason that our health insurance costs so much. It is shameful.
Healthcare should not be so costly.
And, our pets with the same illnesses and medications receive better care at less cost from veterinarians. Just shameful!
Oh, look no further than Congress who made this happen.
Only a strong Congress that is not being bribed can fix this.,
We need to dismantle the stranglehold of the Insurance Companies and Health Care Cartel and start over. It has been done with the will of the people, all we have to decide is to "do it".
Just why I don't go to doctors or clinics anymore?
Broken ankle? I used an elastic wrap and a cane. I only missed 2days of work. I grew up when mom could sew up a serious cut, and broken bones were set at home.
Clinics seem to be pill-pushers of drugs that have more negative side effects than what they cure? Oh, but they have a pill for that, too?
That is exactly what Obama should have taken into account when he made is awful healthcare plan. Not all the ridiculous crap he is heaping on hard working Americans to make us pay for health insurance for poor people.
When a hospital charges 8000 for a service, then your insurance company "adjusts" it by 5000 cause that hospital is a preferred provider, leaving only 3000 to pay, that tells you right there that the hospital is either jacking up the price cause you have insurance or charging WAY too much for the service since you know they aren't going to lose money on services. I am thinking more it's the former. THAT should have been a high priority for that idiot at 1600 Pennsylvania Ave.
I can relate to alot of those things in the article too. Like a doctor charging $400 to tell a nurse to give a shot, then trying to charge for the syringe and drug, which were also billed by the hospital. Duh....it was the hospital's supplies, not the doctors. He took that off when I called him on it. The $400 charge took me 5 months to get someone to tell me what it was. The doc wasn't even the primary doc on the case.
Or being billed the exact same charge by an anesthesiologist and a nurse anesthisist and we never even saw the anesthesiologist. The insurance company paid both with no question but they sure jumped all over it when I called and pointed it out.
I always request an itemized bill from hospitals to make sure they are being honest and I advise anyone to do the same. Especially after a friend told me about the charge they got for a circumcision of their newborn....who was a girl!
You must become a de facto health care specialist. As is for auto insurance. As is for all potentially catastrophic events....
The sad fact is, we are all on our own now. Little policing, regulating or controlling exists to ensure we don't end up indigent.
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