As anyone with cancer knows, hospital procedures are a part of life. You know that even before your appointment date, you will most likely get a call from registration. They’ll take your insurance information and preauthorize the procedure, if applicable. In some cases, hospitals will ask for your share of the cost upfront. You may think that is the end of billing; unfortunately, it is not. Human error may end up costing you a lot of money for debt you don’t even owe. In this blog post, we’ll cover some important facts about medical billing errors, provide a step-by-step guide to doing your own hospital bill audit, and provide three nonprofit programs to get you help with your hospital bills for free. ❤️
Most Bills Have Errors
Medical billing errors are a shockingly common occurrence. A recent study by the Kaiser Family Foundation (KFF) uncovered that over half of all medical bills have errors. And a 2020 report by the Health Care Financing Administration (HCFA) estimated that billing and payment errors cost patients and health care providers $57.5 billion a year.
Think about it. Hospital stays are nothing short of chaotic. During your stay, you will have the doctors who prescribe and perform the treatment, nurses at your bedside providing round-the-clock care, labs that process tests, and then the people who decipher all of these things to put them into code to send it off to insurance for payment. As you can see, there is a lot of room for error.
The Top Five Billing Errors
One simple mistake can be the difference in hundreds, maybe even thousands of dollars. The KFF report outlines five of the most common errors on medical bills to watch out for:
1. Data Entry Errors: These are errors that result in being charged for the incorrect number of things (e.g. two doses of medication when only one was given, or two days’ stay when it was only one).
2. Unbillables: These are items which should not be charged to patients, such as hospital beds, surgical equipment, and reusable supplies like gloves, gowns, and bedding. You should never see these on your bill.
3. Medications: Make sure the number and dosage charged is correct.
4. Incorrect Codes: This is called unbundling. Examples are seeing separate charges for reading lab results or scan results. Reading results should be included in the lab or scan fee.
5. Services Not Received: This is more common than you might think. For example, procedures get ordered and then canceled but can still show up on the bill. Make sure to check your bill carefully to make sure that all charges are legitimate.
Inaccuracies can add up quickly, and that means you end up with an inflated bill you don’t even rightfully owe. By taking the time to carefully review your hospital bill line-by-line, you can truly save yourself a lot of money.
Perform Your Own Hospital Bill Audit
We know the word “audit” is intimidating. But it’s very important to review your medical bills. Why? Because over 50% of all medical bills have billing errors. These could cost you and that’s not fair. You should NEVER pay $1 more than you owe. Follow the steps below to get started.
Step 1: Request an Itemized Bill
You can get a copy of your itemized bill directly from the hospital billing department. Make sure to ask for an itemized bill. The bill you usually receive is just a summary of charges and won’t do. Here’s a template you can download, edit, and use to request your itemized bill.
Step 2: Review Your Explanation of Benefits (EOB)
An EOB is a document from your insurance company that shows what was charged for medical services, what the insurance company paid, and what you owe. It’s important to compare your EOB to your itemized hospital bill to make sure that you actually received the services or products listed on your hospital bill.
Step 3: Understand Terminology
Medical bills can be confusing and difficult to understand. That’s where Merriam-Webster’s Medical Dictionary comes in. It provides clear, concise definitions of medical terms so that you can understand your bill and any other medical documents.
The dictionary also includes detailed entries on medical procedures and treatments, so you can understand what was done during your visit to the hospital or clinic. If you have questions about your medical bills or need help understanding a document related to your health, Merriam-Webster’s Medical Dictionary is a great resource. It’s available online and as an app, so you can access it wherever you are.
Step 4: Understand Billing Codes
The ICD-10 code is a medical classification system that was introduced in 2015. It’s used to record diagnoses and procedures in patient records. The codes are used for statistical purposes, to track medical conditions, and to help with research. If you don’t understand the ICD-10 codes on your medical bill, the CDC website has a tool that will explain them to you. Simply enter the code and the website will provide a description of what it means.
Hospital bills can be complex and confusing. But by taking the time to understand them, you can save yourself a lot of money. With these tips, you can audit your medical bills for errors and make sure you are only paying for the services you need.
Step 5: Understand Fees
It is important that hospital charges are fair and reasonable for the services received. You can look up costs in two national databases, Healthcare Bluebook and FAIR Health. Simply enter your procedure and zip code and you will be able to see typical charges in your area. If your hospital is charging more, it may be time to ask for a discount.
Ready? Audit that Bill!
Here is a free, downloadable Medical Bill Audit Tracker to stay on top of tasks.
Free Help from a Patient Advocate
High medical bills can lead to financial stress and can be an enormous source of worry for patients and families. As a cancer patient, you have enough to worry about. If you have high hospital bills, please consider reaching out to a patient advocate for help. A patient advocate can help you understand your bills, find financial assistance, and fight for fair billing practices. If you are struggling with high medical bills and feeling (understandably) overwhelmed, contact a patient advocate today.
Top 5 Reasons to Use a Patient Advocate
1. A patient advocate is trained to help you understand your medical bills and make sure you are only paying for the services they need.
2. A patient advocate can help you compare your complex EOB to your medical records to make sure that the charges on your bill are accurate.
3. A patient advocate can help you understand your insurance company’s unique payment terms and conditions.
4. A patient advocate can help you make sure the charges on your bill are accurate.
5. A patient advocate is available to help you online, via phone, text chat and email at your convenience.
Three Free Patient Advocate Programs
If the idea of organizing bills, contacting providers, and following up seems overwhelming, that’s okay. We understand; you have a lot on your plate, and we are here to make things easier on you. We want you to know there are free resources available to help you audit your hospital bill and ensure you pay only what you rightfully owe. Here are three national organizations that can assist you today all at zero cost.
Triage Cancer is an invaluable resource for those affected by cancer. It provides comprehensive, up-to-date information and resources on a variety of topics related to the diagnosis and treatment of cancer, including insurance coverage, financial assistance programs, clinical trials, legal rights and more. The website also offers personalized support through its experienced patient navigators who can help individuals navigate their journey with cancer in a way that best meets their needs.
Triage Cancer provides free customized support program for cancer patients, caregivers, and medical staff who need help with insurance billing matters related to cancer care and treatment. Get practical guidance from experts today and all at no cost. Visit Triage Cancer’s Legal & Financial Navigation Program signup form here.
From the Dollar For website: “Dollar For is a national nonprofit that crushes medical bills by making charity care known, easy, and fair. We eliminate medical debt by empowering patients and advocating on their behalf. Dollar For helps patients check if they are eligible for financial assistance at their hospital, prepare and submit applications, and eliminate medical bills.”
Dollar For is a national nonprofit organization that helps patients across the USA dispute medical bill charges, prepares and submits your applications, and gets your medical debt forgiven if you qualify. Services are completely free. If you have unpaid medical bills of any kind for services rendered in the USA, please get in touch with this program for no-cost help today.
CSC Cancer Pro Support Helpline
The Cancer Support Community (CSC) provides a range of services designed to help individuals diagnosed with cancer. In addition to providing emotional support programs, CSC also offers comprehensive patient pro support programs to help deal with medical bills.
The CSC Cancer Pro Support Helpline offers free professional support services to cancer patients and families nationwide. The Helpline is staffed by community navigators, resource specialists and a Helpline navigator who have over 170 years of combined experience helping people affected by cancer and offering guidance, resources and support all at no charge. Call (888) 793-9355 or live chat Monday-Friday 9AM-8PM ET and Saturday 9AM-5PM ET for assistance.
More Free Help is Available
You have the right to pay what is only accurate and fair charges for your hospital stay. We hope the step-by-step guidance in the post will help you spot bogus charges on your hospital bill and save yourself money. Remember though, if you find any errors on your medical bill, it’s up to you to contact the hospital billing office and get it resolved. If you feel that this may be an overwhelming task, an expert patient advocate can help at zero cost to you. Consider reaching out to one of the programs above. For more free programs, products, and services available exclusively to cancer patients and families in the USA, please visit our online directory here. ❤️