10 ways to avoid outrageous
American hospitals are
fleecing patients out of billions of dollars annually, and experts say that while
some of the overcharges are honest errors, many are deliberate.
because hospital bills are next to impossible for consumers to understand, which
means hospitals can hide improper charges behind mysterious medical terminology
and baffling codes.
That's what Nora
Johnson found when her 56-year-old husband, Bill, underwent hip-replacement surgery
in 1999. The cost of the operation was $25,000.
Knowing that her
family would have to pay a percentage of the costs, she requested an itemized
"What I got was five feet of single-spaced names
and codes," recalls Johnson. Written in "hospital-speak," some
of it made sense, she says, while some of it was absurd.
the charge for newborn blood tests and a crib mobile. That stopped me in my tracks,"
recalls Johnson. "As far as I know, my husband never had a baby."
from Caldwell, W.Va., was so shocked by the overcharges she became a trained medical
billing advocate. Today, she audits hospital bills for consumers and for state
employees in West Virginia.
"More than 90 percent of the
hospital bills I've audited have gross overcharges," says Johnson.
on hospital overcharges run up to $10 billion a year, with an average of $1,300
per hospital stay. Other experts say overcharges make up approximately 5 percent
of hospital bills.
"I've seen $90 charged for a 70-cent
I.V. How about $129 for a mucous recovery system? That's a box of Kleenex,"
She's also seen charges for ordinary supplies,
such as towels and sheets, that should be included in the room charges.
says some overcharges are mistakes, but many are deliberate.
are huge moneymakers," she explains. "Their executives enjoy big bonuses."
As a result, "Hospitals have become highly innovative
when it comes to billing, and ordinary citizens have no idea they're being ripped
off," says Johnson, who is affiliated with Salem, Va.-based Medical
Billing Advocates of America.
But making sure that you are charged correctly can be
a daunting task. That's what Richard Clarke found out firsthand shortly after
his father died in 2000.
Despite the fact that he is a former
hospital chief financial officer, Clarke admits, sorting through the bills took
him a year. In the end he found $2,000 in errors.
bills from just one hospital stay will come pouring in, and they come from many
providers: Your surgeon, anesthesiologist, pathologist, labs, as well as the hospital.
you've been victimized by erroneous hospital bills, we'd like to hear about it.
Send your letters to hospital
Bill Mahon is executive director of the National
Health Care Anti-Fraud Association, a group of insurers and law enforcement officials
in Washington, D.C. He says patients are helpless to decipher their bills. As
a result, says Mahon, providers can slip in overcharges.
medical billing system is complicated and confusing," admits Rick H. Wade,
senior vice president of the American Hospital Association, which represents most
of the hospitals in the United States. On December 27, 2002, he told a Dateline
NBC investigative team, "Trying to understand all the code words and jargon
can turn your brain into oatmeal."
And because health
insurance plans have different contracts with differing payment schedules, there
is no single rate sheet you can consult.
Nevertheless, experts say reviewing your bill for
overcharges is vital. For one thing, if you are required to pay
some of your hospital expenses, either as a deductible or a co-payment,
overcharges will come out of your pocket.