Buzz
If you're not questioning the accuracy of every medical bill you get, it might be time to start being more skeptical.
Only 33% of individuals surveyed by Salucro Healthcare Solutions, a healthcare payment company, reported feeling confident that their hospital or medical bills are accurate. The survey aimed to explore how billing and payment problems influence patient loyalty to specific healthcare providers. However, when you're unwell, you're likely not focused on comparing prices or payment options—you just want to recover. Regardless, 47% of the 1,000 people surveyed by the company reported a billing or payment issue during their most recent healthcare experience.
Regarding confidence in bill accuracy, Vice highlighted that 33% seems high, given the number of individuals who can be found online and through social media, dealing with incorrect medical bills. They referenced a 2018 survey from Consumer Reports that revealed two out of three adults with significant medical bills experienced at least one billing problem, with issues ranging from inflated charges to confusing statements and delayed bills.
Why Your Medical Bill Could Be Incorrect
At this point, it’s essential to be skeptical about nearly every medical bill you receive. Even if you go to an in-network emergency room, you may not be treated by an in-network doctor, leading to inflated charges, as Sarah Kliff, an expert on medical billing, has highlighted. You might also face double billing, which occurs when a medical provider attempts to charge you for something that the insurance company has already covered. Or, your treatment could be upcoded, where a less expensive procedure is labeled as a costlier one. These problems may not be intentional on the doctor’s part, but it is illegal for any medical provider to send you an inaccurate bill. Some studies even suggest that the error rate in medical bills is as high as 80%.
What To Do When You Receive a Medical Bill
Before figuring out how to handle a medical bill that arrives in your mailbox, follow these steps:
First, compare the bill with your explanation of benefits (EOB). This is the document your insurance provider sends, detailing what was covered and what part of the cost you're responsible for. Ensure that the date and doctor's name match, and that the amount aligns with the “patient responsibility” line on your EOB.
If there’s an error—or perhaps you don't have insurance and lack an EOB to compare against—you can contact the billing department listed on your bill and request a detailed list of charges. If anything on that detailed bill doesn’t align with the services you received, you may be able to challenge the bill.
How to Challenge a Medical Bill
You might need to spend considerable time on the phone trying to get the answers you need to figure out if your bill was issued by mistake. But don't give up until you get responses that make sense to you.
Before you reach out to the billing department, Kliff suggests consulting databases like Fair Health or Healthcare Bluebook to get an idea of what the usual costs are for the care you received. From there, you can highlight specific charges that seem unusually high and ask the hospital or doctor's office to review them. If care levels are listed on your bill, you can dispute any charges that appear to have been upcoded.
Just because you receive a bill in the mail doesn’t mean you should rush to make payment, even if it says “Due upon receipt” in big red letters. Don’t hand over any money until you’re completely sure about the meaning of your charges and why you’re responsible for them.
