80 percent of medical bills contain errors, accounting for as much as 49 percent of total charges, according to Christie Hudson, of Medical Billing Advocates of America, an organization based in Salem, Virginia. The organization’s website claims that billing abuse costs consumers upwards of $10 billion per year.
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Now there is help available for patients who are caught between their medical providers and their insurance companies. Medical billing advocates scrutinize bills line by line to uncover duplicate charges and non-billable items.
In a telephone interview, Hudson explained, “If you go into the hospital and you’re charged for the cost of the room, or if you’re charged for the operating room, if you see separate charges like charges for gowns , gloves, drapes, linens, the covers that go on lights, all of these charges should be included in the cost of the room and those would be considered non-billable items. Another non-billable item would be being charged for oxygen when a patient is on a ventilator. That’s not something that’s billed separately.”
She described some of the more outrageous charges uncovered by medical billing advocates, such as thirty dollars for a box of tissues (listed on the bill as a “mucus recovery system") and one hundred dollars for a teddy bear (billed as a “cough support system").
Medical billing advocates can also make sure health insurance companies pay for everything they have promised. She estimated that 60 percent of clients have submitted insurance claims which were unfairly denied.
Ms. Hudson explained that normally advocates charge a percentage of the money they save the client. If there are no savings, there is no charge.
Currently, there are no medical billing advocates associated with MBAA operating in the state of Maryland, although there are some in neighboring states.
To find a medical billing advocate, click here.
To learn more about becoming a medical billing advocate, click here.
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Patients who go out of network to obtain care learn the hard way that medical bills for identical services can vary wildly. For instance, a study conducted by CareCore National in 2009 found that for an MRI of the brain, prices charged by providers varied by 325% (from a low of $1,000 to a high of $4,250) and a CT of the abdomen varied by 950% (from a low of $300 to a high of $3,125). Similar variations are found across nearly all procedures and specialties.
The lack of transparency in heath care, combined with the push by many providers to maximize their revenue on the backs of out of network patients and the uninsured has created a cost crisis in America. Unfortunately, even with health care reform, this problem is only going to grow larger as businesses and insurers scale back benefits and shift more of the cost to consumers and employees.
Services like MedicalBillHelper.com offer consumers the same negotiation services that large insurers and self-insured corporations use, leveling the playing field for consumers, by working with physician offices, hospitals and clinics to reduce medical bills to more affordable levels.
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