A's For Your Medical Bill Q's

Health care savings expert Michelle Katz answers your questions.

Jan. 8, 2009 — -- After her husband had a heart attack, Michelle Katz saved $7,000 just by reading her husband's medical bills closely.

Katz recounted on "Good Morning America" today her horrifying ordeal in saving her husband's life and then battling hospital billing errors.

Read her full story here.

After the show, Katz offered to answer your online questions. Well, you asked, and now she answers.

Both the questions and the answers have been condensed or edited. If you do not see the answer to your question here, you may find it at www.michellekatzmsn.com.

Your Questions, Her Answers

Question: After my husband's gall bladder surgery I requested an itemized bill and tried to dispute some of the charges. I was right by his side the entire time he was in the hospital and I know what he was given. One of the more obvious mistakes was charging us for five IV's when he only had three. The hospital's response was to turn my bill over to the collection agency. No negotiating, no response, nothing. Even though it's too late for me, what recourse would you have in that situation? What do you do when they won't respond to your questions and you can't afford an attorney?

- From Judy in Prattville, Ala.

Answer: It would be a good idea if you have documentation to let your state health commissioner, state attorney general, or the proper "state department" know what is going on so it may be investigated in the future.

If you have insurance, let the insurance company know as well as your doctor.

Many people who have insurance do not realize there is a cap. These "little" charges add up and may cause them to be without insurance in the future because they exceeded their cap. BE CAREFUL! The more people that are aware, the more people you can help in the future.

However, when you do locate the proper agency in your state to complain to, state the FACTS only. Keep it to one page and attach your documentation (some agencies have downloadable forms that you must fill out). Also cc the hospital so they are aware the measures you have taken.

Sometimes hospitals may surprise you, especially if your letter gets into the right hands. Hopefully there is not a "next time," but if there is, always request a copy of your medical records as well as an itemized bill ASAP so you can compare both documents. These mistakes are often a case of "fat fingers" and is something a billing manager or patient advocate can take care of immediately.

Question:

In November I went to the doctor with complaints of lower right quadrant pain in my abdomen. I had a CT scan done. Later that day the doctor called and said it was apendicitis. I spent the night and was given antibiotics. The next morning the doctor came in and said "this might be overkill," that a person from the radiology department misread the evaluation of the CT.

Instead of appendicitis it was appendice eplouditca (SP). A surgeon was called in...no surgery was necessary. Because the doctor didn't see the radiology report himself or talk to the radiologist before calling me I feel that he made a very costly mistake. I have called and discussed this with the doctor's business office and I have called the hospital to file a complaint. I don't mind paying my bills, however, this could have and should have avoided. What could I have done?

- From Ann in Hurricane, W. Va.

Answer:

You are alive, right, and thank goodness you got a second opinion.

Unfortunately, we are only human and mistakes do happen, but in the medical field, there is no room for mistakes. It is important that you let the administration know so they can adjust their protocols and be sure it does not happen again, but these things happen, and thank goodness the outcome was not worse! This is why it is so important to have a doctor you can trust to call and keep updated if something like this happens.

First of all, whenever a doctor recommends a major procedure, even if you think the world of them, get a second opinion. (I have a whole section in "Health Care for Less" on second opinions and the proper tactic). Everyone is entitled to second opinions and another doctor may have a solution that your current doctor is not as familiar with.

In your case, it may not have been an option, which is why, when choosing a doctor, you may want to find one who has an "on call schedule" or he/she may give you their cell phone. (This comes after the relationship is established and the doctor knows you will not abuse this privilege.) This way if an emergency does come up, your doctor can be notified and monitor the situation or recommend a doctor who specializes in your diagnosis.

Question:

I have two out of network doctors that I have to see on a regular basis. At least one of them will give me a discounted fee. I have out of network benefits, but by the time insurance factors in their "Reasonable & Customary," I'm still left paying quite a bit out of pocket. I'm saving in an flexible spending account, but is there anything I can do to negotiate directly with my insurance provider to save money?

- From Dina in Washington, D.C.

Answer:

Shop around! About three months before "open enrollment season" or before your policy renews, start looking, just like you would shop for a car, house, or a new pair of shoes to go with that Inaugural Ball dress!

Make a list of what is important to you, things you cannot go without and see what companies come closest to your desires and let them know what other companies are offering. In my book, "Health Care for Less" I have a chart that can help you with this process as well as some questions you might want to consider.

HINT: If you really are attached to a certain MD, ask him or her which insurance he/she likes the best. This is a great way to show your doctor that you appreciate them and in the future, they may be more apt to call in a favor for you.

Question:

I had a C-section last August, and just last week I received a bill from a doctor (not my OBGYN) who I had never seen before, and the bill said it was for assisting my doctor with the surgery. But my insurance company said he was out of the network. I called the doctor office, and they said they were called in by the hospital to assist. Why would the doctor assisting not be one from my doctor's office, and one in my network? Can I appeal this bill? It is $483!

- From Brenda in Louisville, KY

Answer:

No, you cannot appeal the bill. This does happen frequently since hospitals do contract with many specialists that may not participate with your plan. It is difficult to identify who does and who does not participate in your plan. I would still contact your insurance company and explain what has happened. You never know who you may get on the other end, because on rare occasions, the insurance company may give you one "pass." Just be sure to be pleasant and ask what you may be able to do in the future to avoid this type of charge.

Question:

When is it too late to question your medical bill?

- From Lightrose in Hyattsville, Md.

Answer:

The general rule is, question it as soon as you can. The longer you wait, the more people forget. If you are appealing a claim, more than likely, there is a time limit stated in your summary of benefits.