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How to Make Sense of Your Medical Bills in 5 Steps

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How to Make Sense of Your Medical Bills in 5 Steps

According to a U.S. News and World Report article, about eight in 10 medical bills contain some sort of error. That’s crazy high, which also makes it pretty scary, especially since every error on your medical bill results in you dishing out more dough.

With unfamiliar medical codes and terms, however, it’s difficult for you to know exactly what you’re paying for. But, you’re not only the patient, you are also the customer. Therefore, you have the right to scrutinize every medical bill that you receive and demand an explanation on any charge that looks unfamiliar, too high, or downright suspicious.

In this article, we will give you an overview on what to look for on your bill(s) and who to call if you have issues regarding anything. Get out your highlighter and get ready to mark anything that you have a question about. Keep a notebook handy to write down your questions and notes.

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The Basics

When you begin your medical bill breakdown, it’s best if you begin with what you know: your name, address, insurance information, and admittance and discharge dates.[1] If your insurance information is incorrectly inputted, then you will, for sure, be charged more than you should.

Units

If you are given Tylenol in the hospital to help with your pain, you better believe that you will be charged per capsule. These per-item charges can be found under the “Units” section on your bill.[2] If you are being charged for 500 capsules of Tylenol, then highlight this as an item. There’s no way you took that many capsules during your stay. Double check the number of units per line item to make sure you are not being overcharged for items used during your stay.

Medical Codes

Hospitals and doctor’s offices use codes to identify services rendered.[3] You are charged based on the codes assigned. There are many different types of codes, but Current Procedural Terminology (CPT) Codes and International Classification of Diseases (ICD) codes are the most well-known.[4]

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CPT codes are ubiquitous in every U.S. doctor’s office and hospital. These are usually listed as service charges. ICD codes accompany CPT codes to assure that the diagnoses fit the billed procedure, prescription, etc.

We’re not saying that you should complete medical billing and coding training online, but you do have the right to contact the billing office of your healthcare provider and have every single code explained to you. Don’t be embarrassed, you’re not the only one requesting this service.

Service Description

Read. Every. Single. Thing. Yes, the service description section should be plentifully packed with each service and item you are being charged for, even for something like Basic Life Support (BLS). In this section, there will be a lot of abbreviations. If you don’t own a medical dictionary, then we suggest using good ole Google.

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Once you have made sense of the abbreviations, get out that highlighter and pad of paper and jot down anything that you don’t remember receiving, or any charges that seem bogus.

Charges

There may come a time where you receive a medical bill with just a summary of charges and the amount owed.[5] This is unacceptable and you need to call into your doctor’s office or the hospital billing department and request a full itemized bill, complete with all codes, units, service descriptions, and individual charges. Once you receive an itemized bill, you should go down the list and look at all of the charges. If some of the charges seem too high, highlight them.

Never ever think that if your hospital or doctor bill says that it is, then it must be so. Remember, it doesn’t matter if your bill is 10 pages long (heaven forbid) — you need to go through each page, line by line, highlighter in hand, and check that everything is correct. You will pay for any error that you don’t catch. So, it’s up to you to be vigilant.

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If you have any questions at all, make sure that you contact the health provider who sent you the bill. You can also contact your insurance company as well. They will be able to help with medical coding, as well as help you understand your patient pay portion of the bill.

Featured photo credit: Pixabay via pixabay.com

Reference

[1] https://www.nerdwallet.com/blog/health/how-to-read-your-medical-bill/
[2] http://www.medicalbillingandcoding.org/health-insurance-guide/understanding-medical-bills/
[3] http://vitals.lifehacker.com/how-to-navigate-the-confusing-and-expensive-world-of-me-1765507579
[4] http://www.aarp.org/health/health-care-reform/info-03-2011/how_to_read_your_medical_bill_cpt_codes.html
[5] http://health.usnews.com/health-news/patient-advice/articles/2014/07/15/infographic-how-to-read-your-hospital-bill

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