Question: How do I get better access to the billing process? For example, what am I being charged for individual things. More itemized lists.
From: Kelly R.

Answer: When you receive services from a physician and/or hospital, the provider will submit a bill (claim) to your insurance company. You may receive an Explanation of Benefits (EOB) from the insurance company explaining if and to what degree the services were covered. You may also receive a statement from the provider which shows what was billed, what was paid by the insurance company, and what you may owe to the provider. If you find discrepancies in the EOB and statement, contact the provider and the insurance company. Errors do occur or you may have not provided complete or up-to-date insurance information.

It is possible that an error was made in posting the charges. According to a U.S. News & World Report article dated 7/14/07, 90% of hospital bills have some type of error. Examples are double charges for the same service, charge for treatment, medication, equipment that was not ordered by the physician or used, room charge inaccuracies (private vs. semi-private), etc. You may request an itemized copy of the bill along with a copy of the medical chart and pharmacy ledger. Compare the charges with the services and medications listed. Medical bills are often difficult to understand due to payment and clinical terminology. Don’t hesitate to request assistance from the hospital billing department to understand the itemized charges.

Let me share a friend’s story with you. After surgery and a 5 day hospital stay, she received a statement from the hospital showing the hospital charge, insurance payment, and a balance of over $10,000. Needless to say, this was unexpected and quite upsetting. Fortunately, she had worked in healthcare for many years and was also very familiar with health insurance. Upon contacting the hospital’s Patient Accounts Department, she learned that there was a computer glitch in the billing process. The hospital immediately corrected her bill (she received it twice). Because of the large sum, it was quite apparent to her. A smaller amount may have gone by with less scrutiny. Be an informed consumer-know your health insurance and know what services you received.