I recently had to have a kidney stone removed.Â The hospital estimated the cost of the procedure, and offered me a 20% discount – if I paid my portion on the day of the procedure.Â I paid the estimated amount and had the procedure.
Today, I received the actual explanation of benefits from my insurance company.Â I am happy to report that my portion of the cost of the procedure is several hundred dollars less than the amount I paid to the hospital.Â When estimating my portion, the hospital included my full deductible, unaware that, due to several doctors’ visits prior to the procedure, I had already met most of my deductible.
I called the hospital and spoke to the billing department.Â A refund for the overpayment has been issued.Â I should receive it in a week or so.
It’s always a good idea to check – and then recheck – your medical bills.Â Many insurance companies now allow you to view your account information online.Â This makes it very easy to view recent activity and to check account balances.
7 thoughts on “Keeping A Close Eye On Those Medical Bills”
I have heard of healthcare providers like hospitals giving discounts if you pay the bill quickly. But if you have insurance, how do you know what portion of the bill to pay? Or did you pay the full amount, knowing you’d had to wait for the insurance company to reimburse you? that would make me uncomfortable.
If you pay your bill up front before insurance adjudicates the bill, be aware of a few things: 1. many providers if paid up front in full do not submit the bill to the insurance companies (no reason to as they got paid already) so check to make sure they still send the bill out to insurance co.. 2. when bills from providers are sent to insurance companies, there is a place to check on the bill to send payment to insured, not provider-ask them to check the correct box. 3. pend bill and call both insurance company and provider to make sure they are all on same page. Make sure if in-network provider you also get the in-network discount, because paying up front the girl taking your check has no clue as to what the discount should be. If you don’t get the discount from in-network you still will be paying more then you should have even if you get the “pay upfront” discount”. You are being cheated, and I have seen that happen a number of times. I think it is an innocent cheat though.
Medical billing errors are common and your insurance company won’t notice all (or even most) of them. It is up to the consumer to find them. It isn’t easy because medical billing and coding is so arcane and providers are not that interested in helping you pay them less.
I’ve found numerous errors over the years and “saved” thousands by working to have them corrected. One recent episode ended up saving some other folks money too, as I documented here: http://theincidentaleconomist.com/medical-billing-errors/
I have some health-insurance, and the costs are sometimes so prohibitive that I’ve often assumed that an error must have occurred. I know from now on that I’ll give my next bill a second, third, and fourth look over.
On another note, I live in California and I thought there was some bill in place that limited the amount a hospital could charge you if you self-pay for health insurance? Does anybody know anything about this – or if this is the case in other states, too?
Good job checking everything out regarding the billing. Most people would just pay the bill and forget about it. And my condolences on the kidney stone – I’ve had them and they are murder!
I am so glad I passed by kidney stone on my own….I can’t imagine having to have to pay to get it removed.
I am an RN and strongly recommend that each person ask for a detailed list of the expenses from a hospital stay. Go through each item (with an RN friend) and check charges. For example, what are you charged when they start an IV? sometimes you will see charges for 3 IV catheters. Really, did you have 3 IV’s? Probably not. It they missed the first 2 times and got a vein the 3rd you shouldn’t have to pay for that. If someone inadvertently contamintated the sterile field during a procedure for something simple like a urinary catheter or as big as in the operating room setup, should you suck it up and pay? NO!
Now there is a new law that says if there is a medical error you don’t pay for the treatment for that error. For example, if it is documented that you are allergic to morphine and they give you morphine, you don’t pay for all the events that occurred to treat that. For some, that could be thousands of dollars from a Code Blue…..
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