How To Avoid Being Overcharged By A Hospital

By Subodh / April 12, 2013

When medical services are needed right away, so someone goes to the hospital or emergency room, it is unfortunate when patients are overcharged, potentially leaving that person with years of medical debt.
How can you determine what the appropriate cost for each service should be when you are billed for a hospital or emergency room visit?

What to do when hospitals are overcharging patients:

First of all, if the hospital or emergency room did not issue you an itemized bill that shows every single thing you have been charged for, you should request that immediately.

With that itemized bill:

  • Review each service listed. Did you have that procedure done? Did the medical professionals use the supplies that are listed?
  • Ask questions if an explanation is vague for a dollar amount charged. For example, if your bill simply shows $400 for IV Supplies, find out what exactly those IV Supplies are, and why they result in a $400 charge to you.
  • Check for duplicates. Is your bill showing that you had blood drawn 4 times during your week stay in the hospital? Did you actually have blood drawn 4 times? Double check the accuracy of recurring procedures.

Avoid Being Overcharged By A Hospital

  • Question the need for services that you did receive more than once. For example, did the x-ray tech inaccurately perform an x-ray, so the next day resulted in you needing another one? If you did not mess up the x-ray or cause a reason for a second one, then you should only be paying for the initial procedure.
  • Review the charges that may have been automatically added. In many cases, there are groupings of services or materials that come together when a person is, for example, having a baby. Check your bill to be sure that everything included in the itemized list was carried out and used during your particular hospital stay. If you did not request a “disposable mucus recovery system” you still may be charged for that box of tissues that you used up while staying in that hospital room.
  • Check for quantities listed on the bill too. You may have gone through 3 boxes of tissues, but you have been charged for 300 boxes of tissues because someone accidentally hit a couple zeroes. Review quantities for everything listed.
  • Look for charges that simply seem too high for the item listed. Outrageous markups are frequently found. Should you be paying $4.00 for a cough drop?
    • A great tool for cost comparison is the Average Wholesale Price Red Book, printed each year, that lists the AWP for Medicare and Medicaid reimbursement rates.
    • Medications are a large part of the AWP, and you can use the dollar amounts listed as a benchmark for how much you are paying during your hospital stay.
  • Find out if any delays were added to your stay, meaning, did a nurse or doctor purposefully delay test results, or the ability to perform a procedure, so that you would have to stay in the hospital another night?
    • Under many insurance plans, a certain amount of days are covered, so if a hospital staff has tried to get you stay for the full length of your insurance coverage, then you may not be obligated to pay for the full stay.
  • If you do not have health insurance, you may need to seek professional help on evaluating your itemized hospital bill because of discriminatory billing.
    • Ask about cost shifting. Find out if you have been charged in a way that puts more of the financial burden on you than would have been if you were covered by a medical health insurance plan.

Take action when you have been the victim of hospitals overcharging patients.