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January 24, 2018

10 Tips for Understanding Your Emergency Room Bill

When it comes to ER bills, it is advisable to question everything. There are no hard figures, but experts estimate that about 40% to 80% of all medical bills have errors. This is quite astounding; you have to be especially watchful when you go to an ER such as Frontline ER. They are open all day and night for the whole year. Thus, there is usually no free time to recheck records. It is up to you to ensure you get proper bills. Here are some tips that can help you.

Emergency Room Bill Tips

  1. Keep tracks of things

Whether it was just a short dash to the ER or something which required extensive testing on you, record everything. Ensure that you record even minor details such as discharge and admission times, the test and its nature, any medication, and much more. If you are too sick to keep a record of everything, ask your friend to help. Even some scribbled notes will usually suffice to help you understand the bills later.

  1. Ask for an itemized bill

Hospitals usually prefer to send a summary bill, listing charges under broad categories. However, most of the hospitals will give you a detailed bill free if you request for it. If you still find it hard to understand the bill, ask to be given the doctor’s orders and nursing notes. This will include all the treatments, tests, and drugs you were given. Besides that, ask to see the details bill that hospitals send to insurers.

  1. Check the dates and times

It is important that you compare the room and board charges on the bill against the admission and discharge time. Most insurers will not allow hospitals to charge patients on the day they are discharged. Thus, if the discharge day is included, call to ask if that is correct. If the bill includes surgery, check the time listed. It is especially so if the operation was delayed. In most hospitals, operations rooms are billed by the minute at a rate of $69-$270 a minute.

  1. Check the personal data

If the patient’s name or the insurer’s group number has some mistakes, the coverage being paid might not be correct. Besides that, ensure you are being billed for the right level of the hospital room. For instance, check whether you were billed for the private or semi-private room. In the ER, care is described as level 1 for things such as nosebleeds to level 5 for serious emergencies like a heart attack.

  1. Check for duplications or services not offered

Humans, who are prone to human error, prepare the bills. It is quite common to be charged for one test more than once. In some cases, you may even be charged for more medication than was offered. Check the notes from the doctor against the bill to ensure that you do not pay more than you should.

  1. Check your bill for unbundled items

Lab tests are usually bundled together as a package to lower the costs. If you had several lab tests performed, check with your insurer to confirm if they should have been billed as a single package. If you see any terms that you do not understand, ask for clarification. This will help you know if they should be charged as bundle items.

  1. Look for brand-name drugs

If there is any brand name medication on the bill, you should question whether they were necessary. You should also question whether there were cheaper generic drugs that the hospital could have offered you. If the doctor recommends a generic drug, but the ER offers the brand name drug, the patient should not be charged for the extra cost.

  1. Watch the decimal points carefully

Between $67.00 and $670.00, there is only a single decimal point difference. However, this decimal can raise the price of care a lot. It is important to note that clerical errors do occur and it may be up to you to stop them. If you think something looks outrageous, always ask the ER for some clarification.

  1. Hire a consultant

For huge medical bills, there is a new category of professionals called medical bill advocates. They are good at challenging insurer denials and negotiating lower fees for patients. However, their service is not free. Some will charge you a percentage while some charge an hourly fee. Whichever one you pick, ensure that they have enough experience doing what they do.

  1. Check the codes on the medical bills

For billing and insurance purposes, each diagnosis has a code. Slight variations in the code can indicate a more serious condition that requires more money. It is important that you check the codes in the doctor’s orders against the codes in the medical bill. If the codes do not match, you should ask for detailed responses from the ER where you receive treatment. This usually works when you ask for the codes to be revised.

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