Imagine you’re writing a check for a couple thousand dollars to a hospital. It’s not for charity or for a treatment you received, and you’re not made of money. You hand it over just because. Now, imagine that you have already written that check. It wasn’t for the greater good, or for higher quality treatment, it was simply because some of your medical bills were miscoded, but your insurance company and hospital did not bother to look for miscalculations.
Are you a little upset?
It’s not uncommon for patients to pay for a medical treatment they didn’t receive, or for equipment that didn’t need to be used, or to overpay for a healthcare service—our clients receive bogus bills all the time. Medical billing errors in this country may be as high as 80%, the Wall Street Journal reports. And the Washington Post reports that of 11,000 people surveyed, only 5% could spot an error in their bill.
So if you’ve ever been sent a medical bill and thought, “Why on earth was my routine procedure so expensive?”, then requested an itemized bill—only to find that both you and your insurance rep can’t decode this mysterious charge anyway, don’t worry. You’re not crazy, and you’re not alone.
One blogger, The Incidental Economist, writes,
In the past five years I estimate I’ve found nearly $2,000 worth of errors in my medical bills. It isn’t that my family uses a lot of health care (we don’t) or that we see unscrupulous providers (we don’t). It is just that I am aware that there are a lot of medical billing errors so I look for them, and I find them. Last month I found one. I questioned a $680 charge on a medical bill and followed the trail back to the source of the error. What I found amazed me: a nearly $1,000,000 hospital billing mistake!
When the Incidental Blogger concluded his investigation into the $680 charge on his bill, he found that he was not alone—for three years, other patients had seen the same errant charge. The source of the error: a computer glitch.
Computer glitches and out-of-touch insurance reps aren’t the only causes for billing errors. A recent NYT article reports:
… some spinal surgeons have turned to consultants — including a Long Island company called Business Dynamics RCM and a subsidiary, the Business of Spine — that offer advice on how to increase revenue through “innovative” coding, claim generation and collection services.
Then there’s the problem of drive-by doctoring, a practice that some doctors are saying has become commonplace. An out-of-network doctor or healthcare worker performs tasks that an in-network nurse, resident or assistant could perform, and bills the patient for tens of thousands of dollars. One patient received a $117K bill from an assistant surgeon who he didn’t even remember meeting, while another patient, admitted to a hospital for emergency back surgery, who later received a hospital bill including services he did not realize had occurred.
Here at Sherpaa, our clients present us similarly expensive and traumatic errors.
When one of our clients gave birth earlier this year, the hospital sent her a bill for $2,880. It turns out, her provider billed her insurance company with the wrong ID number. Needless to say, she didn’t have to pay the $2.8K.
Sometimes, it’s not just an error that’s at stake. A different client was billed $6,400 for a four-night hospital stay. This was a little more complex: it wasn’t a stay that their insurance company normally covers. But our Insurance Specialists are reluctant to back down, and after we made our appeal, stating that it was a medical necessity, our client’s bill was reduced to $200.
Our healthcare system is rife with mistakes, small and large. With eight out of ten hospital bills containing errors, the average bill is 25% more expensive. It’s no wonder that when patients and procedures alike are labelled as mere numbers, you’ll find a few miscodings. But we’d rather not see the patient picking up the tab for someone else’s carelessness.
ABC News and the Incidental Economist both offered remedies for our national affliction. ABC News suggests you buy a software review package, or if the bill is too complex, get a claims assistance professional. The Incidental Economist took a more DIY approach, and he offers a step by step account of how he rid himself of the $680 error. He’s a veteran of spotting errors in his own bills and by now has a “usual procedure of inquiry”. Both options can be time-consuming, risky, and imprecise.
Sherpaa offers you an easier way: send us all your bills before you pay them. Our experts will check them for errors, curate appeals to your insurance company if you think something should be covered, and you can just sit back, relax, and keep your checkbook in your pocket.