Billing Problems - Part II
Author: DorisGoodbody Total views: 8 Word Count: 484
For this article we look at another problem. And unlike the first problem this may be built into the system. One could argue it was intentionally built into the 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.
On the CBS New program 60 Minutes there was a quote from a spokesperson from the American Hospital Association. Basically she said that hospitals charge the same for a service whether a person has insurance or not. The bugaboo is that not everyone ends up paying the same.
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.
Lets try to break it down. Every hospital has a master list of charges, it is called the "charge master". That list contains the prices for all the services and supplies in the hospital. But when patients are billed some are given discounts from the full Charge Master price.
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.
Anderson knows about this, he helped write the Medicare rules that form the basis for what government and insurance companies pay hospitals. Asked why this can happen and Anderson replies; "It's a long historical evolution, but 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.
That will be the basis for our next articles. What Richard Clarke has done to help us all.
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About the Author
Hospital Bills are infuriating, annoying, prone to errors and sometimes down right incorrect.
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