Preventive Care for the Pocketbook
Sunday, June 27, 2004; Page F08
To guard against errors and overcharges in hospital bills, consumer advocates recommend the following:
• First, understand your health insurance plan. Before you begin your hospital stay (if it's not an emergency), review your policy's "exceptions and exclusions" section to learn what it will not cover.
• Make sure your insurer has your correct personal information, such as your Social Security number, and make sure other information is up to date.
• Call the hospital's billing department ahead of time. Ask which items may be excluded from the price of your room (facial tissues? hospital gowns?) so you can bring your own. Will you need a cane? Again, take your own. What costs $10 at a medical supply store may cost $60 when the hospital supplies it.
• Check whether the hospital, surgeon, anesthesiologists, radiologists and anyone else responsible for your care are part of your health plan.
• If you can, keep your own log of tests, medications and treatments. Or ask a friend or loved one to do so.
• Wait for an "explanation of benefits" statement from the insurer before paying any bills. Compare it with the hospital bill. Report discrepancies to the hospital and the insurer.
• Always insist that the hospital give you an itemized bill. Don't pay a bill that lumps charges under summarized headers such as "hospital incidentals." Every state now requires that hospitals provide itemized bills upon request.
• Ask your insurer whether certain hospital fees should be bundled. For instance, should the cost of the surgical drapes and floor mats be included in the price of the operating room? Should the blood tests done in one day be combined as one charge?
• If you suspect an overcharge for operating room hours, check the anesthesia record. It states start and end times for surgery.
• Keep a log of procedures and medications you receive during your hospital stay or have a family member do it.
• Check for common billing errors, including typographical errors and incorrect dates of service.
• Not satisfied? Ask the hospital, the insurance carrier -- or both -- to audit the bill for errors.
• Some medical providers warn that an audit may work in their favor. "But only one bill out of thousands that Medical Billing Advocates has looked at through the years has had charges added to it" after an audit, said Nora Johnson of Medical Billing Advocates of America.
• If the matter is turned over to a collection agency, notify the agency that you are disputing the bill.
• Never sign a payment plan that you can't comfortably afford.
For more help, contact the consumer protection office of your state attorney general (phone numbers are listed at www.naag.org). For a fee, consultants at Medical Billing Advocates (www.billadvocates.com) can help decipher your bill. The People's Organization in Detroit offers a free service.
SOURCES: Consumer Reports, Medical Billing Advocates of America, Bankrate.com
© 2004 The Washington Post Company