Billing Problems - Part II

The first part of the problem was human error, the second problem is not. In fact you might argue it is intentionally a part of the billing system.

I may be cynical and the problem maybe happenstance, but nonetheless it gives me great cause for concern. You see all the caregivers you encounter in your hospital stay want to provide quality care. Be they techs, nurses, dietitians or phlebotomists, we all have the same goal. But I am not so sure that is the case for the billing department.

I have seen and audited a great many hospital and medical bills. So even though that last statement about billing seems bold I am still dumbfounded with the blatant excesses I see on the bills.

In future articles I will go over some sample bills. I will show you how they are set up, and believe me it isn't with consumer readability or understanding at the forefront.

Here is a quote that aired on the CBS News 60 Minutes program. It comes from Carmela Coyle of the American Hospital Association. "Actually, what hospitals charge for a service is the same for everybody, whether they have insurance or not. What's confusing for everybody is that what a person ends up paying in this country can be very different."

Huh? You mean that a portable chest x-ray costs the same for every person in the country but we may all end up paying different amounts?

This just one of the confusing parts of medical billing and reimbursement. And that is what I mean by being built into the system.

Here is how it works in a nutshell. A hospital has a "charge master" that is a giant list of prices for all services and supplies provided by the hospital. So when a patient is billed for a service the charge master is consulted. However, you as a patient may receive a discount on the full Charge Master price as listed.

But to make matters worse, hospitals keep this charge master secret. And as Gerard Anderson, a professor of public health at Johns Hopkins University notes, "That information isn't available to you. In the hospital sector, you can't do any comparative shopping. And because you can't do comparative shopping, the hospital has no reason to control prices." Thankfully that is beginning to change however.

I would call Dr. Anderson an expert on this. He helped the government draft the rules Medicare uses to reimburse hospitals for services. So his assessment is valuable, and asked why hospitals can do this Dr. Anderson said in part "... essentially, they can get away with it."

You may think this will never happen to you, after all you have insurance and are in good health. But one day it will just as it did with Richard Clarke. And perhaps it is good it did happen to him because he began the Patient Friendly Billing project.

Next time we will look at how Richard Clarke has helped all of us with confusing hospital bills.

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Hospital Bills are confusing, annoying, prone to errors and sometimes down right incorrect.

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Billing Problems - Part II

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