How to Review Your Medical Bills
Medical bills are complex and hard to read, making it difficult to see exactly what you are paying for. We tend to see charges being lumped together instead of them being itemized from hospitals or clinics. With many clinics and hospitals going paperless, it is not uncommon for patients to not even receive statements in the mail regarding how much their insurance plan has paid. We will share some tips on what to look out for as you are reviewing information.
After Your Service
After being discharged or leaving from your services, it is important to keep and review the summary that is sent home with you. Here is where you will find services rendered as well as follow up care that you may need from your visit. This summary is great to use to reviewing your medical bills.
Explanation of Benefits
Your Explanation of Benefits (EOB) comes directly from your insurance plan. This document will explain how much the service was, the amount the insurance company paid, and any reduction of the service cost. It is not uncommon when using in-network benefits, that you will receive a lower billable amount on your service.
Facility and Provider Charges
This statement will reflect what the facility and the providers are charging for their services . This document will share a list of services preformed with the charges associated with each service. In theory, this should match the document that you received when you left the facility. It is not uncommon that health systems are no longer issuing itemized bills, which would help you find errors much easier. You do have the right to request an itemized bill from the facility if you feel something is missing or wanting to confirm you are being charged correctly.
Review and Take Action
Now that you have these documents, it is best to start reading over each document separately and noting any charges that you do not understand or items that you think that you should not have been charged for. The bill will use codes for each of the services, which can in return complicate understanding the charges. To best learn what these codes mean, looking them up online or finding a medical dictionary can help. Then simply compare the documents to one another making sure that each charge matches up.
Common Errors
Review your statement for duplicate charges. Data entry can cause errors with coding and you may find that there are missing numbers or even “accidental” zero placed in the billing code. Medical billing/payments have multiple parties reviewing data entry. Here are 5 common medical billing errors.
- Incorrect billing - Services never received and still charged for.
- Unbundling of services - Medical coding can group services that are preformed together. Unbundling could cause higher bills.
- Duplicate charges - Have same service listed more than service received.
- Upcoding or undercoding - Wrong medical code used for service.
- Rejected not denied - Patients information was not documented correctly.
Find an Advocate
If you are new to a diagnosis or treatment process, ask you doctor as well as the clinic about anticipated costs or future medical coding that will be used with your care. This way you can review how your insurance plan will cover them before you are being charged. Schatz Benefit Group is a full service broker that assists questions like this every day for their clients. Their services are at no cost and will help simplify the process for you.