How to challenge your medical bills

BY JIM MILLER, Savvy Senior Published: June 18, 2012
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Dear Savvy Senior:

I need some help understanding my medical bills from my knee replacement surgery earlier this year. My wife and I live on a pretty tight budget so I like to keep track of our costs as closely as possible. But the bills I’ve received are vague and confusing, and we think we’re being overcharged. What can you tell us?

-- Trying To Recover

Dear Trying:

Errors and overcharging have become so commonplace on medical bills today that double-checking them is a very smart move that may save you some money. Here are some tips and tools that can help.

Challenge your bills

According to the Medical Billing Advocates of America, nine out of 10 hospital bills have errors on them, most of which are in the hospital’s favor. Bills from doctor’s offices and labs have mistakes too, but they tend to be fewer and further apart.

To help you get a handle on your medical bills and check for costly errors, the first thing you need to do is request an itemized statement from the hospital or health care providers detailing the charges of the procedures, supplies, tests and services they provided you. They are legally required to provide you with this information.

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.