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May 14, 2009 4:11 PM

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Yup, during my first (and only, knock on wood) hospital stay when I was a kid the bill had a charge for a painkiller injection of some sort that I refused. At the time, I would have rather had the achy pain of a borked collar bone than deal with needles.

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May 14, 2009 4:13 PM

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\"Errors\" ??? More like fraud.

But then, since I'm an insurance fraud analyst, it all looks like fraud to me...

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Drew5764

May 14, 2009 5:12 PM

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@jswilson64: Indeed, the checkout one stands out as being absolutely intentional. I'm all for a parking ticket-esque system - one mistake anywhere, and it's all dismissed.

Well, maybe on it's face, but in actual practice I think that'd drive costs up instead.

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redkamel

May 15, 2009 4:59 AM

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@Drew5764: Im pretty certain you have to be out by a certain time to not get the charge. Just sayin. And I doubt its delibirate, unless its on the billing departments fault. The docs and nurses dont have anything to do with billing (except listing exactly what they did and didnt do, and theres not a lot of making-things up)

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jc364

May 15, 2009 5:10 PM

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@redkamel: And how many of these \"mistakes\" are in the hospital's favor?

If it isn't deliberate, then hospitals sure aren't in a hurry to correct the problem.

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May 14, 2009 4:25 PM

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@jswilson64: I'd be inclined to agree most of these \"errors\" are very deliberate.

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May 14, 2009 4:14 PM

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I'm not sure what the incentive is for the consumer to find billing errors if insurance is picking up most of the bill. Example: I had a hospital stay in December for a cardiac incident. The total cost of care was in the neighborhood of $60K, of which I had to pay a little less than $2K. Insurance paid whatever they were obligated to pay after their discounts, which was something like $38K.

Now, if I were to take the considerable time and effort to pore over my bill to look for errors, and point out to the hospital that they had double-billed me for towels, what are the chances that I'd see a dime from the savings?

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ajlei

May 14, 2009 7:33 PM

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@PunditGuy: I said it before, but I'll repeat. Every medical billing error I've had has been an incorrect billing code entered. Each time, the codes were not covered by insurance and cost around $90 each. I had to go through this whole appeal system to get them to change the billing code to what was actually administered. And yes, it was worth my $180.

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May 14, 2009 6:16 PM

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@PunditGuy: There may be plans in the U.S. where people would pay nothing out of pocket for medical care, but nobody I know has or can get one--everybody still spends real money on health care on top of their plan, so they'd definitely want to fix any errors that cost them more. And I've had coding errors that make a doctor visit into something that insurance won't actually cover, so those I regularly pursue. (There's one recurring instance, so yeah, it really is \"regularly.\")

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bohemian

May 14, 2009 6:12 PM

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@PunditGuy: Most people have a co-insurance amount they have to pay. If they are tripling the actual cost of your total bill your smaller amount could have been 1/3 what it was. But if you like throwing money away send some to me.

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May 14, 2009 7:15 PM

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But if you like throwing money away send some to me.

This is absolutely a situation where I would be willing to throw away money, because I very much doubt that going over my bill looking for errors will be worth my time.

This wasn't a hypothetical situation that I dug up -- these were real-ish numbers (obviously reduced in significant digits, but in a very close ballpark). So my share of the total bill paid was about 3 percent. Assuming -- and that's a big assumption -- that any reduction in that bill would reward me at the same rate, a $60 towel overcharge is going to net me $1.80.

There is no way that they tripled the actual cost of the bill -- the insurance company isn't in business to pay out anything unneeded, so they'd crack down hard on something like that.

Let's assume the total bill was inflated by 10% -- which is probably a little bit high, but definitely in the realm of believable (as opposed to 300%). That means that I could have saved about $200. Sounds great! But in going over the bill, how the heck do I know that Tylenol is going for $6 a pill instead of $7? How much does 1 hour of a cardiac rehab specialist's time cost? There's no way it would be worth $200 of my time to investigate every line of the bill.

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Adrienne Willis

May 14, 2009 7:59 PM

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@PunditGuy: I can tell you this from an ER visit I had on Christmas Eve, they charged my insurance company $90 for Tylenol I never received!!! $90? The screams to me that they are abusing the fact that insurance companies will pay for anything they put on a bill.

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usul356

May 15, 2009 1:50 PM

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@Adrienne Willis: I think you just brought up the whole reason our health care system is messed up, Insurance Companies. From my personal experience, when my insurance company said they wouldn't pay for a visit to the ER the hospital so kindly dropped $800 off my bill so it would be like uninsured people. How in the world can a company just drop around 30% of a bill at the drop of a hat? Or how can they not feel sleazy by charging an extra $800 to the insurance?

Just because of \"so called arrangements\" how can they drop $22K off of PunditGuy's bill either? They need to reform the health care system not by giving more money to these middle men insurance companies and giving everyone insurance. They need to reform it by cutting out insurance all together. Once that is done they also need to require hospital and doctors offices to give pricing out front. I can tell that a burger is gonna cost me $5 at this place and $8 at this restaurant, so why can't I tell what just a stupid doctor's visit is gonna cost? It's not a free market system if it's not easy to get price comparisons.

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Adrienne Willis

May 14, 2009 4:17 PM

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@PunditGuy: I am no expert but I am guessing it would save on insurance costs in the long run, maybe lower or stay at same rate co-pays, deductibles, etc. I would assume that costs are so high now because of double billing, errors in billing, etc.

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May 14, 2009 4:25 PM

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@Adrienne Willis: I'd agree with that if the insurance company had paid everything the hospital was asking for. As it stands, the hospital ended up with something like 33% less than it said it was owed. I'm guessing that if either I or the insurance company went to the hospital to point out the towel situation, the hospital could point to their missing $20K and say \"we'll subtract it from there.\"

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Brian Douglas

May 14, 2009 4:57 PM

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The 22K that the hospital had discounted was due to a contractual agreement the hospital has with the insurance. Every insurance pays a different amount, so doctors and hospitals submit claims with an amount that's over all those amounts because the insurance will not pay over what's billed. And the insurnace states when it pays exactly what the patient can be billed and what the patient cannot be billed.

So \"we'll subtract it from there\" would just get a retort of \"Then we'll subtract it from your next payment.\"

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downwithmonstercable

May 14, 2009 4:37 PM

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@PunditGuy: Wouldn't it lower the amount you're responsible if your insurance covers a percentage? Paying your 20% share (or whatever amount it is) of $9,000 is less than 20% of $10,000.

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savdavid

May 14, 2009 4:23 PM

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The thing is you don't know what is the correct rate for most things, the hospitals fight you on every dispute and they know most people don't have the time or money to dispute the bills.

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bohemian

May 14, 2009 6:14 PM

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@savdavid: The frustrating one I ran into was that the hospital would totally stonewall the entire thing. They take something they actually did but code it at a higher costing option. IE: turn a clinic xray into a hospital \"outpatient\" xray by slapping a bracelet on you. Really if a hospital wants to be jerks about it who are you going to go to when they ignore or refuse your dispute.

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redkamel

May 15, 2009 5:01 AM

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@bohemian: I always thought a clinic x ray and an outpatient x ray were the same thing. Anyhow, sometimes its faster to get something done one way than another. Otherwise you get people complaing about how long they have to wait for an x-ray.

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May 14, 2009 4:37 PM

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I am considering going to school to learn medical billing & coding; I found this article to be interesting.

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gStein_*|bringing starpipe back|*

May 14, 2009 4:46 PM

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and people like me, don't care- my family fulfills the out-of-pocket minimum by the end of january each year, having 2 kids with diabetes. we chose to pass the bills off to the insurance company to fight, because it makes no difference to us, cost-wise (i know someone is going to complain about this thought process, but i just can't be bothered to check my bills if i'm not paying for it. Think about this - you have a corporate credit card, in your company's name, that they pay off in full each month. do you bother to check it?)

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Adrienne Willis

May 14, 2009 5:03 PM

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@gStein:how do you feel when the next year your insurance rates go up even more and then more the year after that? When the out-of-pocket/deductibles/co-pays become more than you and your spouse can afford, do you then start caring? I dont know if you have insurance through your employer but do you really think they are going to absorb more of the cost for your healthcare each year?

If we do something now, point out these inaccuracies, false billing, etc then we may have a chance of saving ourselves money that we will need in the future.

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May 14, 2009 9:35 PM

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@Adrienne Willis: Maybe a portion of that increased cost could go to pay the salary of someone who's job it actually was to identify fraud and waste in bills. Of course, that would require health insurance companies to be in the business of actually insuring health care costs, not simply in the business of collecting premiums from a cherry-picked pool of the people least likely to get sick or have health problems.

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jackal676

May 14, 2009 4:58 PM

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This is quite relevant to my current situation. I just had oral surgery, and I was billed for quite a bit of operating room time, but my oral surgeon told me the procedure would only take an hour and a half or so. Hmmm, how to get to the bottom of this?

On a side rant, it's pretty disgusting to see itemized charges of even a short hospital stay. I was charged about $800 just to sit in a reclining chair in a tiny curtained-off room for about 45 minutes. That's all that happened. Oh, and they gave me two little pudding-cup-sized containers of apple juice. Recovery Room 2 carries quite the premium.

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May 14, 2009 5:43 PM

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I challenged a bill I got for a doctor's visit for a sinus infection. There was $10 for a \"blood oxygen test.\" I know what that test is and at no point did anyone slip anything resembling a blood oximeter onto my finger or measure it in any other way.

The hospital's response? \"We bill insurance for it whether we do it or not, because it's part of a standard office visit.\"

Oookay. Sounds like fraud to me.

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aloe vera

May 14, 2009 6:28 PM

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When I gave birth to my daughter 2 years ago (via c-section) I was billed for room and board and then my DAUGHTER was billed room and board as well. We stayed in the SAME ROOM and they weren't the ones feeding her!

At the time I just didn't have it in me to argue the charges.

And after reading this article I don't even want to look back to see if we were billed for the day I was discharged. I probably was.

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May 14, 2009 8:29 PM

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@aloe vera:
That is the dumbest thing I have ever heard. How do they get away with this crap?

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greggen

May 14, 2009 6:28 PM

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Our company made a big deal out of 'being better consumers' of medical care and urged us to check our bills to lower the cost for all.

When I went through some of the bills, they were not itemized. The Doctors refused to provide itemized bills to me, my insurance did not care. My HR rep looked at me blankly when I asked them to lean on the insurance co to demand itemized bills so I could 'be a better consumer'

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May 14, 2009 6:51 PM

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Headline reads 80% of bills have errors.

Article reads 'up to' 80%.

Well, if you want to get literal, up to 100% of doctors' bills may have errors. But I'd guess the actual number is much lower than 100% or even 80%. But nice try Alarmerist.

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May 15, 2009 6:51 AM

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@backbroken: (Up to) 80% of Consumerist articles contain grammar and/or spelling errors.

Actually, that might be higher than 80%.

But I like the \"Alarmerist\" thing.

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ajlei

May 14, 2009 7:16 PM

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I've had doctor visit bills that have had incorrect codes. The times it has happened to me, they've always been codes that my insurance wouldn't cover, because they were for some obscure vaccine or antibiotic (that I didn't take) and it would be this huge hassle to get them to fix it back to the regular doctor visit codes. So, it does matter to fix those because I would've been on the hook for what amounted to an extra $90 those times, which is considerably more than the $25 co-pay I expect to pay.

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Lisa Cebrian

May 14, 2009 7:18 PM

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well they assume that a 3rd party is paying (for the most part) so how many people check these items and call the hospital and say \"hey you overcharged/double charged me!\" even if someone notices, they think \"well, I'm not paying for it\"

just imagine how much hospitals would rip of the government if the government was paying for everything...yeesh. if this simple problem was fixed, a lot of our health care cost problems would be solved.

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corellia40

May 14, 2009 7:54 PM

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My mom has twice been charged for prostate exams, and when my sister was born my parents were charged for circumcision. No two were at the same place or with the same doctors. The insurance companies didn't even notice. In fact, I believe one of the prostate exams was charged on a bill that also included a Pap.

Apparently, hospitals either make assumptions without checking the sex of the patient, or just believe they can get away with a lot - and if it's the latter, I'd assume they have at least some justification for that.

My mom called and fought them on it every time though, so go Mom!

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May 15, 2009 12:02 PM

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@corellia40: That's the dumbest thing I've heard in a while.

I thought it was bad when the doctor charged my monogamous, married, lesbian partner for a $70 pregnancy test as part of \"standard bloodwork\" for the flu (w/o first asking if she could be pregnant*) but you win. In fact, you win by a landslide.

*Yes, I understand some people have motivation to lie about these types of things. But we were self-pay and were not informed of the test until the bill showed up.

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May 14, 2009 8:31 PM

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Okay, I take my reply to aloe vera back. THIS is the dumbest thing I've ever heard! Check under the diaper, you dinks!

(PS - Go corellia40's Mom!)

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gStein_*|bringing starpipe back|*

May 14, 2009 11:51 PM

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@HogwartsAlum: in the hospital's defense, you were charged for an attempted prostate exam - when they failed to find the prostate, they decided to check the sex of the patient.

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May 14, 2009 8:35 PM

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I'd like to know if this is legal. My stepfather had a cyst on his neck lanced and my mother had some fluid squirt into her breast via needle for a test. Their insurance listed both procedures as surgical procedures so that they could charge them more. Is that right?

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jackal676

May 15, 2009 7:14 PM

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@Span_Wolf: I read your second sentence thinking that all happened at once in some horrible accident, and I was very grossed out until my left brain hemisphere got some oxygen.

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May 15, 2009 6:53 AM

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@Span_Wolf: I don't know the whole procedure, and I'm not sure how you know the intentions of the hospital's billing department.

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Sara Morrill

May 14, 2009 9:31 PM

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I'm in the middle of disputing a bill right now, so this article comes as no surprise to me. For some reason, the routine ultrasound anatomy scan that I had performed in the 20th week of my pregnancy was billed as some crazy high-risk procedure that my insurance is refusing to cover. I've been going back and forth between my provider and my insurance for the past two months (apparently they are incapable of speaking to each other) trying to have this matter taken care of, to no avail. In order for the insurance to accept responsibility for payment, the doctor's office that billed them must change the procedure code for which I was billed, but they're refusing to do anything because they've \"already appealed it\" - never mind that the appeals were squashed because they resubmitted it with the same billing code that generated the error in the first place! It's really frustrating, and I have a new surge of sympathy for people who wind up with medical collections, because I'm pretty sure that this is how they happen.

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gStein_*|bringing starpipe back|*

May 14, 2009 11:54 PM

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@Sara Morrill: it's in the insurance company's best interest to pay as little as possible (in the long run), and it's in the MD office's best interest to charge as much as possible. insurance knows that when they deny the claim, you get stuck with the bill... (i know this comes off as a bit cynical or bitter, but if you look at the basic business models for each company, it's true)

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Anonymous

May 14, 2009 9:34 PM

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I feel sorry for you guys in the USA. Health care should be a basic human right, not a for profit business. We have it set up right in Canada.

What I find funny is that our neighbors in the states defend their right to get ripped off by their health care system. Its sad when people are brainwashed. I have never worried about going to the doctor, or getting hurt, or the wife having a baby. Hell our prescription costs are way lower up here for drugs.

I compared my taxes with that of a friend in the states, and when all his taxes and health care costs are totaled. MY TAXES ARE LOWER THEN HIS.

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Anonymous

May 14, 2009 9:56 PM

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If only there were some way to pass a law requiring hospitals to publish their billing codes on a web page - so we could all see what each one charges for each thing, compare prices, and evaluate our bills. But that would require Congress to grow a set, so don't hold your breath.

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humphrmi

May 14, 2009 10:35 PM

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I'm one of the lucky ones with decent health insurance through my employer.

Except for misbilling that results in my insurance denying the claim and me having to chase up to get it corrected, overbilling from my providers usually goes like this:

Provider: Bill for X procedure, for $1000

Insurance: Payment as negotiated for X procedure, $50

In other words, I just let the insurance company handle it.

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humphrmi

May 14, 2009 10:37 PM

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@humphrmi: Oh and I should have mentioned that my insurance company strictly enforces their \"patient is not responsible for charges above and beyond negotiated rate\".

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eric54

May 15, 2009 10:07 AM

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Excuse me while I visit doctors, receive medical attention as needed and heck while I'm at it get checked up on whatever else is bothering me.

Pectus Excavatum surgery (Nuss Procedure) costs 30,000.00.

I paid nothing. Seriously US, get a universal health care service!

- America got just about everything right but healthcare. Now take a lesson from your northern neighbors and get on it!

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May 15, 2009 2:24 PM

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How about the old \"We gave you a service you never authorized\" bill? Before having our second child, my wife switched pediatricians because she didn't like the doctor any longer. Mind you, she was going to the same OB/GYN the whole time, and they were different doctors in different practices.

Anyways, the day our second child was born, a doctor from the pediatrician's practice showed up without our knowledge, checked records or whatever, we have no idea, and a year later we get a bill for their services. My wife wondered WTF they were billing our second child for since we never took her there, and when we called we found out what they did. My wife raised holy hell, ending up calling the CEO of the practice (it was a large medical facility in our city) and got the charged wiped out.

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kaceetheconsumer

May 16, 2009 8:39 AM

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Yeah but when you call to dispute, the provider blames the PPO, the PPO says you have to talk to the insurance company, and the insurance company blames the provider. They trap you in this misama of pointed fingers and shrugged shoulders, hoping you'll give in and pay.

I've got one going now where another party I have no relationship with has inserted itself and the provider says it is that company tacking on the extra charge, but nobody is willing/able to fix it so I filed a complaint with the state body overseeing such things but haven't heard back yet.

Seriously, I've learned that the biggest benefit I had when I lived in Canada was that I didn't have to waste so much time and stress constantly chasing all of this crap down.

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