Understanding your medical bill is often no simple matter. Most are filled with specialized terminology, confusing acronyms and indecipherable numerical codes. In one survey, 60.5 percent of respondents rated their medical bills as confusing or very confusing.
The nonprofit Patient Advocate Foundation estimates that about half of all medical bills contain incorrect charges, wrongly denied claims or surprise fees. “They may charge you for the wrong service or charge you twice for the same service or say you had an ibuprofen when you didn’t,” says Caitlin Donovan, spokesperson for the organization. Spotting an error can save you thousands of dollars, she adds. “That’s why it’s so important to scrutinize your bill.”
In addition, many medical providers don’t include an itemized list of charges when they first bill you, especially for a hospital visit. Instead they lump all the charges together in what's called a “summary” bill, with a “total due” at the bottom. And some initial statements don’t factor in payments from Medicare or your insurance company, which could give you the impression that you owe more than you do.
Take these steps to understand your medical bill, spot costly errors and avoid paying too much.
If your bill does not include a detailed list of charges, call the doctor's or hospital's billing office and ask for an itemized invoice. That's the only way to make sure you're being charged just for services you received.
Get an itemized statement
If your bill does not include a detailed list of charges, call the doctor’s or hospital’s billing office and ask for an itemized invoice. That’s the only way to make sure you’re being charged just for services you received, explains Pat Palmer, cofounder and chief executive officer of Beacon HCI, which helps employers and other health care payers identify billing errors and reduce costs.
Remember that you may receive additional statements from physicians, surgeons or specialists such as anesthesiologists, radiologists and pathologists who are not employees of the hospital or facility where you were treated. Request itemized bills from those providers, as well.
Check the basics
Make sure your name, address and other personal information on the bill are correct, and verify your health insurance information. If this information is wrong, it can lead to a claim denial.
If your bill includes an “adjustment” or a “plan discount,” that’s the difference between the full fee a doctor or facility charges for a service and the rate negotiated by your insurance company.