Getting Robbed at the Hospital

By Amanda Buchanan – The Motley Fool.

High hospital costs seem to be a fact of life that most Americans have reluctantly come to accept. What most people don’t realize, however, is that not all of those charges are legit — and in fact, many medical bills contain fraudulent charges.

In 2010 alone, Medicare and Medicaid paid an estimated $70 billion in improper hospital payments, according to a 2011 Government Accountability Office study. But it’s not just nameless, faceless bureaucratic entities getting hit up for costs they shouldn’t have to pay.

Brett Goldstein, author of The Retirement Crisis, started questioning his hospital bills after his daughter underwent a minor procedure that left him with unreasonably high bills. After digging into it, he realized he was being cheated in more ways than one.

Goldstein’s experience can be used to help others make sure they’re not being overcharged for medical care. Here are red flags to watch for the next time you get billed:

5 Signs You’re Getting Robbed at the Hospital

1. Double billing:
This one could be an innocent mistake. There are many departments within a hospital, and it can be difficult for each one to know what the other is putting on the tab. For example, the hospital may charge for your anesthesia, and the anesthesiologist might charge you again. A quick review of your bill should reveal mistakes like this.

2. Bills for services not rendered
If you can, pay attention at the hospital (or designate somebody else) to make sure you only get billed for services actually provided. Sometimes the slip-ups are easy to overlook, like being charged for an extra dose of antibiotics that was never actually administered.

3. Up-coding and up-selling
This is another easy one for the average person to miss. You may be diagnosed and treated for the flu, but charged for treatment of bronchitis. A quick Google search can help you verify the codes on your bills.

4. Excessive fees
When Goldstein first started looking over his daughter’s bills, this was one of the first things that stood out to him. “When I looked at my bill for my daughter, the operating room charge was $7,400. I thought that was excessive for a 20-minute procedure. The hospital tried to justify the cost by stating that it took an hour and a half to reset my daughter’s leg, which means they charged me for the time it took to prepare and set up, which they are not allowed to do.” The physician fee schedule search tool at the Centers for Medicare & Medicaid Services website provides payment rates to use for comparison purposes.

5. Out-of-network doctors
This is a tough one. Most doctors are independent contractors, not hospital employees. So while you may go to an in-network hospital, it’s not uncommon for an out-of-network doctor to treat you. Unless you ask, you have no way of knowing up front. In emergency situations, asking your doctor what insurance he accepts is likely the last thing on your mind. But if you or someone you are with has the presence of mind to ask, your savings account may thank you for it later.

Feb 8, 2012

Editor: Although the publication date of an article may not be current the information is still valid.