How to challenge your medical billsPublished 10:51am Friday, June 22, 2012
If the statement contains confusing billing codes or abbreviations that you don’t understand, call the billing office for an explanation. You can also look up most medical billing codes online by going to any online search engine and typing in “CPT” followed by the code number.
Once you receive and decode the statement, review it carefully and keep your eyes peeled for these mistakes:
• Double billing: Being charged twice for the same services, drugs, or supplies.
• Typos: Incorrect billing codes or dollar amounts.
• Canceled work: Charging for a test your doctor ordered, then canceled.
• Phantom services: Being charged for services, test or treatments that were never received.
• Up-coding: Inflated charges for medications and supplies.
• Incorrect length of stay: Most hospitals will charge for the admission day, but not for day of discharge. Be sure you’re not paying for both.
• Incorrect room charges: Being charged for a private room, even if you stayed in a semi-private room.
• Inflated operating room fees: Being billed for more time than was actually used. Compare the charge with your anesthesiologist’s records.
To make sure the charges on your bill are reasonably priced, use the Healthcare Blue Book at healthcarebluebook.com. This is a free resource that lets you look up the going rate of health care costs in your area.
If you find errors or have questions about charges, contact your provider’s billing office and your insurer. If they don’t help you and the discrepancies are significant, you should consider getting help from a trained professional who specializes in analyzing medical bills and negotiates with health care providers, insurers and even collection agencies.
Most medical bill reviewing professionals charge an hourly fee – somewhere between $50 and $200 per hour – for their services, or they may work on a contingency basis, earning a commission of 25 percent to 35 percent of the amount they save you.
To find help, check out resources like Medical Billing Advocates of America (billadvocates.com), MedReview Solutions (medreviewsolutions.com), Hospital Bill Review (hospitalbillreview.com) and Medical Cost Advocate (medicalcostadvocate.com). You can find others by doing an Internet search under “hospital bill review.”
If you’re a Medicare beneficiary, another resource that may help is your State Health Insurance Assistance Program (SHIP). They provide free personalized counseling and may be able to help you get a handle on your medical bills and Medicare coverage. To find a local SHIP counselor visit shiptalk.org, or call 800-677-1116.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.