Disputing Medical Charges

I would only call if we were being charged for things we didn't receive. Anything else would just be a pointless waste of time.

Chances are they are not going to remove charges for items that were actually administered. Healthcare is a business, and charges for running the entire establishment need to be built into everything that is charged. Keep in mind that built into the charge for an item is the cost associated with delivering it.

A $5 tablet of aspirin takes into consideration the employees that stock & manage the pharmacy & the nurse who gives it to the patient, for example. The hospital is not going to run to Walgreens & pick up the $2 bottle of lidocaine & give it to you at straight cost.

If you have insurance, they will not make changes to the balance, because there is already a discount built into the "covered charges" assumed by the insurance company before copays & deductibles are passed onto the patient. But if you are self pay only, they may offer a self-pay discount off the entire bill. I know in WI there is a discount equivalent to the greatest discount offered to insurance companies.

T.

You cannot dispute the bill for overcharging... unfortunately.
When you sign the admission paper you basically say that you will pay for whatever they charge you, some clinics even charge facility fees... completely legal, not related to any service you receive, just for the pleasure of "using their facilities".

If they billed you for medication or services that you did not receive - those are charges that you can dispute.

A hospital can charge you however much they want for anything you get there. Many people argue that healthcare is so unaffordable in this country because there is absolutely no regulation of what doctors/hospitals are allowed to charge you. Part of these outrageous charges is because they have to cover the cost of patients who cannot pay for treatment, part of it is to make profits (many hospitals are for profit companies...they have to make a buck, that's their objective).
You can surely call and complain, but you still have to pay.
Good luck.

You do realize part of that charge is for a nurse to administer it, the pharmacist to pull it, the clerk to chart it, etc...the actual med is probably a small portion of the fee for that action.

They also have to pay someone to wash his sheets, mop his floors, empty his trash, sanitize the operating room, supply the heat source to incinerate his refuse, there are many many many things that have to be paid for and each thing has a charge that takes those things into consideration.

I was on life support years ago and in the hospital for almost four months. Needless to say that our bill was enormous! We also requested and itemized bill and found many mistakes, including that I had a baby while in there!! I did not. They may have not been happy about it, but they corrected the problems. Good luck to you when you talk to the hospital. It's absolutely ridiculous how much they charge for things. :)

Yep, sure have. Medical care is not cheap. That's why the medical profession is so profitable. The med profession employs many people who have gone to school to get educated and licensed so that we can have optimal health care.

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Add up all the charges and compare it to your EOB and you will find those aren't the actual charges. Usually they explain this before they will send out an itemized bill. The allowed amount on your EOB is your actual charges.

This is a "pay it forward" industry. Just think about all the less fortunate people you've helped. Let it go and count your blessings for having "good" health insurance.

Part of the increase in cost could be due to the fact that a lot of meds are compounded by pharmacists in the hospital. What may cost $2 for a bottle over the counter was produced in mass quantities by an automated system. What you get in the hospital may have been compounded by hand by a pharmacist who put it together based on individual patient needs. Then the med is usually hand checked by a second pharmacist to be sure it is the correct dosage for that specific patient. It is then delivered (sometimes by hand, sometimes by pneumatic tube) to the floor where the patient is located. It is again hand checked at least once or twice to be sure it is the correct med going to the correct patient. Before a nurse can administer the med it is again checked and logged to verify that it is the correct med going to the correct patient. That happens even with a saline bag because most IV drugs look the same. A good portion of the cost of meds in a hospital setting are for all the checks and balances to be sure the patient is getting the correct med.

"Real businesses" are not transparent in their costs. Do you have any idea what the mark up is for fountain pop? As much as 600%. Movie popcorn? As much as 1200%. Bottled water? Up to 4000%. A latte? 300%

Yes, medical expenses are outrageous, but I guess I would rather "sign away my life" when it comes to medicine than to pay 4000% more for water than I need to.

There's a heck of a lot of overhead included in those charges.

The only thing you can dispute is charges for things you did not receive. You can not dispute how much they charged for services you received.

I am assuming you have health insurance. The hospital can put whatever price they want to on the itemized bill. They have a contract with the insurance company to pay a flat amount that will be substantially smaller than the amount listed on that bill. You will pay a further smaller amount, whatever your copay or deductible is. If you have a deductible you will still only pay what the contracted amount is with your insurance company. You should get an "EOB" Explanation of Benefits from your insurance company that will show you what you actually have to pay vs what the hospital charged.
Now, if you don't have health insurance. Well. You will have to talk to billing. There is very often a reduced amount that they will charge you after going through the paper work to say you do not have insurance. We ran into this when we were on COBRA. They didn't charge it right and charged us as though we didn't have insurance, the full amount. After contacting them they charged us the uninsured amount which was much lower than the full amount. Once all the paperwork caught up and they charged COBRA correctly that was the amount we finally paid in the end.
Those huge amounts that are listed on the itemized list are their attempt of subsidizing all those people that receive heath care but can not pay the bill at all. Is it wrong? Yes. But it is reality. They can't endlessly loose money and it's not right or fair to turn away someone from life saving treatments even if they can't pay. Hopefully the Affordable Health Care act will begin to curb it as more and more people have health insurance and the hospital have more and more bills paid then defaulted on.

So, check through and make sure everything on there belongs on there. If it does, see what your insurance requires you to pay. If you don't have insurance, call up the billing department and they will help you through the system of what needs to be done so you do not have to pay every penny of the bill.

When I had my first son, I went in to the hospital for a low-intervention induction on a Saturday that didn't work. I went home for 24 hours to see if things would get started in a less stressful environment. Then I went back Monday for a (really awful) intervention-loaded induction. They initially charged me for a complete induction and delivery on Saturday and then another complete induction plus C-section on Monday-Wednesday. So according to their records, I gave birth on Saturday, went home, gestated another baby, then came back and gave birth again on Wednesday.
All that to say, check the records for accuracy, for sure. But as frustrating as it is, they very likely will not change their pricing policies for you, other than offering existing discount pays for self-pay.
In the future, you do always have the right to shop around if it is a non-emergency procedure.

I would definitely call. Nothing may change, but you should still voice your concern, and remind them you could go to another hospital in the future if the prices continue to be outrageous. Hospitals are businesses just like any other, and they don't want to lose "customers".

I requested an itemized bill after the birth of my son. I couldn't believe all the bogus charges; I was charged 3 times for saline, and never even had an IV! I was charged twice for Pitocin (assumably one bag before and one bag after birth), but again, went completely natural with no IV! I totally called them on it, and it took a year to get a new invoice. While the overall bill didn't go down a ton, it did delay us needing to pay the balance for a year, which was nice. And this was at the hospital system where I am a nurse. I was glad I requested the itemization; they had definitely messed up.

You only dispute erroneous charges, things you did not receive.
The bill you received is for services (& products) rendered. Did you
bring your own saline or lido etc?
It's the cost of doing business, of getting health care in a hospital etc.
The same applies to cable bills for the tv, car insurance, eating out (the
grilled chicken dish I order is much more expensive than if I stayted
home & grilled it myself.
Not trying to sound harsh, just realistic.
I have learned from past experiences what can be disputed (erroneous
charges over thinking something is costly) and what can't.
Just be thankful that we have hospitals to go to with qualified staff.
I have received great care & am thankful to be alive after a scary stint
in a hospital.

Absolutely you should call. In what other area do we simply accept the charges for services rendered, without a way of knowing before hand what we will be paying?

Hospital charges are largely made up, and have little to do with the actual costs involved in a procedure. I have no problem paying for my medical costs and a reasonable profit, but hospital bills often reflect a markup of a thousand percent or more, and the fact that these are the prices charged to people who have limited ability or no ability to refuse the services at the prices offered is just plain wrong in my opinion.

Here is a link to a story that ran in Time Magazine a few months ago about this:
http://livingwithmcl.com/BitterPill.pdf
it's long but worth reading if you haven't yet.

Anyway, I think you should complain and request a lowered bill. If you are serious about getting it reduced you can Google "disputing hospital charges" but at the very least I would request that they lower the amounts to those payed by insurance companies, or better yet, request to pay what Medicare pays.

Good luck!

It's not worth calling to complain if that's all you want to do. You'll end up speaking with a nice person who agrees with you that medical billing is crazy... and all you'll do is waste her time and yours. You're not going to be able to talk to the CEO of the hospital who has a hand in setting prices. So take a deep breath, hug your kids, go run in the sunshine... and let it go.

It is absolutely ridiculous what they charge! And if you really pay attention, they have probably charged for a few things your hubby didn't even get/have. It's all computerized - for x condition, the treatment is y even if you don't actually get everything y consists of, you are still charged for it.

So, if you can find things he didn't get or have, then you can dispute those charges, but nothing else is going to be considered. It's a racket - kind of like the mafia. You have no choice but to pay.