Special Report: Why a Hospital Bill Costs What It Costs

Special Report: Why a Hospital Bill Costs What It Costs© altrendo images/Stockbyte/Thinkstock

3. Supplies and appointments are hard to track.

Even with regular audits and billing software to ensure accuracy, hospital bills are subject to honest human error. One common problem: getting charged for something that didn’t happen. Say you’re in the hospital for surgery, and a CT scan scheduled for Tuesday morning got canceled because your condition changed. “Eight out of ten times, that charge is still going to show up on that bill because it was put into the system and not taken out,” says Palmer.

Other errors include double billing or charging for items you didn’t use. “I remember watching a few catheterization procedures,” says June Morgan, a coding educator specialist with the AAPC. “As additional supplies are pulled, the person who hands them to the doctor tells someone else the part number so it can be added to the bill. But sometimes it’s hard to hear the part number, and it has to be repeated, so you can see how the patient could be billed for supplies not used, or not billed for supplies used, or billed for duplicate supplies.”

In still other instances, “sometimes supplies are pulled for a procedure like an echocardiogram before the patient arrives,” Morgan says. “If the patient cancels or is a no-show, the supplies should be returned and credited to his or her account. But sometimes the staff just uses those supplies on another patient instead, leaving the charges on the wrong account.”

To save money: Maintain a patient log. Avoid mistaken charges by noting what happens during your hospital stay. Granted, when you’re laid up, you’re not thinking about billing. But to the extent possible, you or a family member could keep a notepad by your bed and record the tests and medications you receive—and any that are canceled—along with the dates.

Plus, keep track of the time. Some charges, like those for time in the operating room, are determined by the minute. Have a family member note when you go into and come out of surgery, suggests Palmer. “ORs may cost $200 per minute, so if you’re billed for two hours but your husband knows you came out after one, that’s thousands of dollars in savings.” The recovery room, where per-minute charges are also used, is another area to pay attention to. “Sometimes patients get stuck in recovery simply because nobody is available to take them to their regular room,” says Palmer.

Bring your own supplies. Everyday items could mean more bucks on a bill than you expect, says Palmer, who has seen $10 charged for a diaper in a nursery and $119 for an egg-crate pad given to a patient who required support in bed. “If you end up needing one of these regular supplies,” she advises, “just have a family member get it from a drugstore or bring it from home.”

Finally, get an itemized statement. A typical hospital bill divides charges into broad categories, such as Laboratory, Radiology, or Pathology, without much detail. Palmer advises that you request a detailed itemized statement—which can be 15 pages or longer—that breaks out each specific charge. If you don’t understand an item, ask the billing department to make sure it matches the care you received.

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