Medical bills can make you ill: Avoid phantom expenses

The intravenous dye cost the hospital $14. The patient’s bill for it? Try $600.

“That’s more than a 4,000 percent markup. I think about that bill a lot,” said Holly Lang of Georgia Watch, a nonprofit consumer advocacy group.

Then there are stories of $11 for a box of tissues — also known as a disposable mucus recovery system. Or $15 for thermal therapy. We call it an ice pack. Tylenol for $140. A charge of $30 for a thermometer or $52 for a commode.

According to the Medical Billing Advocates of America, 80 percent of hospital and medical care bills have errors and overcharges on them. The chances that you’ll get stuck with a bill more painful than any needle are extremely high.

“I would say that is the norm,” said Cindy Holtzman, a member of  MBAA and owner of Medical Refund Service. “It’s horrible, or we wouldn’t be out here.”

More than 36 million Americans have medical debt, in many cases leading to bankruptcy. Making matters worse are common and outlandish billing errors that consumers can ill-afford. Hospital bills, in particular, are often complicated and combing through them is time-consuming and overwhelming, especially if you’re trying to instead focus on getting well.

But, it pays to pay close attention. If not, you could find yourself paying for a private room when you shared a room with another patient. Or paying for six nights in the hospital when you were there for four.

If no one ever drew blood, you probably shouldn’t be charged laboratory fees. Why is there a charge for a radiologist if you went in for a virus and never had an X-ray? A stroke of a keyboard caused a coding error, so you were charged for 41 intravenous treatments, instead of one.

“You’ve got the physician seeing you and someone else keying in the data,” said Holtzman, who is based in Woodstock. “The front office is preparing a bill. The doctors don’t even have a clue [about the billing]. They are doing their job, which is helping you with respect to treatment.”

That’s where advocacy groups like Georgia Watch, MBAA and the Alliance of Claims Assistance Professionals come in. Georgia Watch’s hospital accountability project started in 2007 and is a small organization compared to the for-profit groups like MBAA and ACAP that generally charge a percentage of your total bill or a percentage of your savings. You could pay an hourly fee of $100 or more. Plus, there is no licensing currently associated with the advocacy business.

They are comprised of health care professionals with backgrounds in insurance and medical billing. They can negotiate with your insurer to appeal coverage denials, work to get you lower fees and dispute charges on your bill. While it isn’t cheap, the hundreds or thousands you could have in medical bills makes the service worthwhile.

“Sometimes this is so complicated, you want to throw up your hands,” said Dr. Margaret Lewin, medical director of Cinergy Health . “Don’t do that. There are professionals who can help you go through your bills.”

And you can help yourself.

• Never leave the hospital without an itemized bill. After you’ve been discharged, it is harder to get.
• Ask questions and take names. You should know who is treating you, and for what. If the patient is unable to keep track of who is providing treatment, a spouse, friend or relative should take the responsibility.

“You do that even when you’re taking your car to the shop,” Lang said. Said Holtzman: “You’re not going to go to the grocery store and pay $75 without seeing a receipt.”

• Never pay the bill immediately upon discharge.

“You need time to digest it; to go over it,” Lewin said. “Under no circumstances should you do that.”

• If you can plan your hospital visit, be aware that for the un-insured, nonprofit hospitals are often more willing to work with patients on discounts.
• Don’t let the hospital shrug off a bill and tell you insurance will pay for it.

Most important, remember you’re your own best advocate.

“Patients need to make sure they are empowering themselves,” said Lang. “People just accept what the [bill] says. I’m not saying be argumentative, but the consumer has a strong role.

Where to go for help:

hap@georgiawatch.org or 404-525-1085

billadvocates.com

claims.org

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Email rcash@ajc.com