GMA: Hidden Costs in Hospital Bills

April 12, 2001 -- A closer look at your hospital bill could reveal that you have paid big bucks for thermal therapy (hospital jargon for ice cubes in a bag) or disposable mucous recovery systems — a.k.a. tissues.

And you're not alone.

A group of auditors hired by insurance companies recently found errors in over 90 percent of the hospital bills they examined. An audit by Equifax found that hospital bills that totaled more than $10,000 contained an average error of $1,300.

The reasons behind the mistakes range from double billing to human error, but the bottom line is the same: Someone always pays.

Patients No Longer in Clear

In the past, the average patient didn't have to worry about errors in billings because if a health care provider overcharged, the insurance company picked up the bills and the patient landed in the clear.

But today, any claim denied by insurance companies comes out of the patient's pocket no matter what the policy's out-of-pocket limit, because that limit only applies to what the insurance company agrees to cover. If they don't agree to cover all or part of your treatment, you are responsible for paying.

There are steps that patients can take to protect themselves and specific errors to look for. The first step is obtaining an itemized bill from the hospital, and a copy of your medical records.

Hugh Delehanty, editor of Modern Maturity magazine warns that this may not be an easy task because hospitals do not like to have people scrutinize their bills. But persistent patients can get the information they need.

Double-Takes From Doctors

The next step is carefully scrutinizing the bill for errors.

The most common way that hospitals and medical labs can overcharge is known as double-billing. This happens when a doctor bills a patient separately for tests or procedures that are performed at the same time.

If a doctor performs two procedures during the same surgery but charges as though they were done independently, for example, that is double billing. It should be billed as one procedure, and the costs should be lower.

Some doctors will charge you for a consultation if they simply stick their heads in the room and glance at your chart. If a doctor bills you for a service that another doctor is already providing, that is double billing.

Anything on your bill that is packaged should also stir your curiosity. For any item that is labeled a "tray" or a "pack", make sure you know what is included and that you were not billed for services separately.

Everyday Items, Exorbitant Prices

Another common cause of overcharging occurs when hospitals bill for simple objects shrouded in technical jargon.

One hospital even used "disposable mucus recovery system" as a name for tissues.

A patient in Illinois was charged $57.50 for a cough support device that turned out to be a teddy bear. He thought it was a gift.

And because insurers tend to scrutinize big-ticket items, some hospitals will overcharge for everything from aspirin to pacemakers.

Mistakes also occur through clerical or computer errors.

Hospitals deal with hundreds of insurance companies and government agencies, all of which use different codes and rules. Patients should not have to be charged for human errors by medical personnel, however.

One common example involves X-rays. If your X-ray film does not develop correctly, you may be charged for it even though it isn't your fault.