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What If I Get an Incorrect Medical Bill?

HandelontheLaw.com Staff Writer

Thursday, November 07, 2013



What If I Get an Incorrect Medical Bill?
Medical Bill

A medical bill is the second blow of illness’ one-two punch. Worse yet, busy hospitals and medical offices can easily overcharge and/or impose duplicate charges, resulting in an unfairly high bill. Fortunately, there are several established steps that can be taken to eliminate those unfair charges and reduce your medical bill. This could eventually involve many facts and documents, so keep an expandable file for all your documentation and notes. Also, read all the steps before starting, as some overlap and/or replace other steps.

First, you have to know about the charges in order to remedy them, so don’t simply pay a bill that gives only a brief summary of charges and a total amount owed. Rather, give the appropriate billing department a written request for an itemized bill and keep a copy of your request. Hospitals and many medical offices have staff designated for issuing requested detailed bills, so this is usually the only step you will need to take in order to receive your itemized bill. If you do not receive the itemized bill, send another request – mentioning your prior request - by certified mail, and keep copies of this request and the postal receipt. If you still do not receive the itemized bill, send a written request to the highest appropriate authority (usually the Chief Executive Officer or Chief Financial Officer) of the hospital or medical office – mentioning both your prior requests – by certified mail, and keep copies of this request and the postal receipt. If none of these actions works, have your lawyer write a brief letter demanding the itemized bill. You will receive an itemized bill.

Second, review the itemized bill for duplicate charges, overcharges, charges for services you did not receive, charges for equipment or materials that were not used to treat you, essentially any charge that conflicts with your recollection of your treatment.

Third, write to the hospital/medical office billing department, telling them that your itemized bill has items and/or services that were incorrectly billed and listing each disputed item. Request that the billing department sends a written response to you, either removing each incorrect charge or documenting the support for each incorrect charge. Keep a copy of your letter.

Fourth, if the billing department fails to remove every incorrect charge or give you adequate documentation for each disputed charge, send a letter by certified mail to the highest appropriate authority (usually the Chief Executive Officer or Chief Financial Officer) of the hospital or medical office. Tell this “higher up” that you have tried to resolve your billing dispute with the billing department but it has not been resolved. Include the same statement that your itemized bill has items and/or services that were incorrectly billed and list each disputed item. Request a written response to you, either removing each incorrect charge or documenting the support for each incorrect charge. Keep a copy of your letter and the postal receipt.

Fifth, if anyone from the billing department or the CEO/CFO has spoken to you about this disputed bill, keep a running record of the name, phone number, date and substance of the call.

Sixth, if the previous steps have not resolved your billing issue, file a complaint you’re your State’s Department of Public Health or Insurance. The State web site should have the appropriate links and forms for filing your complaint. In California, for example, the Department of Public Health maintains a web site at www.cdph.ca.gov that allows you to file complaints online and/or through a printed PDF document by: clicking the “Health Information” tab near the top of the home page, which will take you to another web page; then clicking the “Health Facilities Consumer Information System” link, which will take you to another web page; then clicking the “Consumer Complaints” link on the left-hand side of that web page.

Seventh, if the bill is too complicated for you to decipher, hire a professional medical billing advocate. These advocates, who can be found online via any major search engine (such as Google or Yahoo!), will scrutinize your bill and argue with the appropriate billing departments/higher ups to remove erroneous charges or otherwise lower your bill. Typically, these advocates charge a fee or a percentage of the amount saved, and might be well worth employing.

DO’S AND DON’TS

DON’T be intimidated by the process or the people.

DON’T simply pay a bill that gives only a brief summary of charges and a total amount owed.

DO keep an expandable file for all your documents and notes.

DO keep a record of every person with whom you discussed your bill (including name, phone number, date and substance of the call).

DO obtain an itemized copy of the bill.

DO review the itemized bill for incorrect charges.

DO write to the billing department/higher up telling them that your itemized bill includes incorrect items, list the items and request a written response either removing the incorrect charge(s) or providing documentation for the incorrect charge(s).

DO keep copies of all documents related to your bill and your attempts to correct the mistaken bill.

DO file a complaint with your State’s Department of Public Health or Insurance.

DO hire a professional medical billing advocate if your bill is too complicated for you to decipher.


Kathy Catanzarite

[Note from HandelontheLaw.com: This article is to be used as an educational guide only and should not be interpreted as a legal consultation. Readers of this article are advised to seek an attorney if a legal consultation is needed. Laws may vary by state and are subject to change, thus the accuracy of this information cannot be guaranteed. Readers act on this information solely at their own risk. Neither HandelontheLaw.com, or any of its affiliates, shall have any liability stemming from this article.]


Source: Kathy Catanzarite - Handelonthelaw.com Staff Writer

Note from HandelontheLaw.com: This article is to be used as an educational guide only and should not be interpreted as a legal consultation. Readers of this article are advised to seek an attorney if a legal consultation is needed. Laws may vary by state and are subject to change, thus the accuracy of this information can not be guaranteed. Readers act on this information solely at their own risk. Neither the author, handelonthelaw.com, or any of its affiliates shall have any liability stemming from this article.





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