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Linda
Brandwin, R.N.
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Linda
Brandwin
is a registered nurse and a medical billing
and claims specialist. For the past 10 years
she has worked directly with insurance companies
to give advice and guidance to the health care
consumer.
Readers may send email
or write Linda Brandwin at 5500 Single Oak Hill
Ct., Woodbridge, VA 22192.
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Deciphering
hospital bills can be difficult
Aug 27, 2004
Q:
My
husband's father and grandmother are in the hospital
frequently. How do we know that their hospital bills
are correct? Sometimes I have the feeling we are being
ripped off.
A:
Deciphering
hospital bills is very difficult. If surgery was needed,
it is even more difficult to understand the bill. The
medical language on an itemized hospital bill is not
only intimidating but the entire bill is almost impossible
to verify for total accuracy.
Look
at one hospital date at a time. Go through all of the
charges for each day separately. The more you are able
to break down the hospital bill into smaller components,
the easier it will be to understand. See if the charges
make some sort of sense to you. Some hospitals provide
a free service that will help you review your hospital
bills. You can also talk to the billing department for
guidance. They may be able to direct you to a designated
person trained to answer patients' billing questions.
Also, your physician may be able to assist you and answer
your specific questions regarding hospital charges.
Again, hospital bills need to make some sort of sense.
For example, if you were hospitalized for heart problems,
perhaps you were charged for six EKGs. That makes some
sense and is possible. But someone should be able to
check your chart and confirm that six EKGs were performed.
However, it does not make sense that during this stay
you were also charged for three strep throat cultures.
That would be a red flag item that needs to be checked
out.
Verifying
surgical charges is by far more difficult. How do you
know six sponges were used and not five? Many surgical
charges are based on time factors, such as the number
of minutes used for the operating suite itself. Again,
talking to a hospital billing representative or a physician
may help you sort through some of these charges.
Some hospital surgical departments have bar codes on
all of their supplies. Everything used in the operating
room gets scanned for an accurate accounting. Also some
hospitals film the surgical procedures. This is probably
a more useful tool when lawsuits are involved, but might
also be used for reviewing controversial billing charges.
You can always request an audit of your hospital bill.
The hospital might charge you for this service. And,
remember, it is possible that errors could have been
made in your favor, which after the audit could even
cost you more money. That is why I have stressed that
the bill should make some sort of sense to you. It is
difficult to verify every single charge, not impossible,
but extremely difficult. If you have used the resources
mentioned above and the hospital bill seems reasonable,
then you have accomplished a lot. You have a much better
understanding of your bill now. However, if there appears
to be many errors and red flags that jump out, by all
means request an audit.
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