PSI: Challenging your medical bills

by Jamie Boll - bio l email | produced by Jeff Keene - email

CHARLOTTE, NC (WBTV) - Sandra and Thomas Alexander have had their share of big hospital bills, but it was actually a relatively small one that gave them headaches.

"I called and said I paid this," said Sandra Alexander.

She paid half of it in August, the other half in September, $139 total.  So, imagine the surprise when come November she started getting calls from a collection agency.

"Everyday they'd call," said Alexander.  "Five, six, seven times a day."

It turns out Alexander made a simple mistake.  She put the wrong account number on the checks she sent in.

Mistakes in medical billing are more common than you might think.  Many times the issue isn't with the patient, its with the hospital, or the medical provider.

"I'm not well liked in the health care industry," said Pat Palmer.

Palmer once worked for a large health insurance company.  Fifteen years ago she started Medical Billing Advocates of America.  A Salem, Virginia based company that helps patients challenge their sky high bills.

"I'm conservative in saying, what comes through our office, at least eight out ten bills are wrong."

She says many of the charges on bills are unwarranted, some appear more than once and others are simply ridiculous.  Palmer says the overcharges can total in the tens of thousands of dollars on an individual bill.

Palmer says she has found examples of hospitals charging $59 dollars for teddy bears and calling them cough support devices.  She says she has also seen cotton swabs billed at $8.75 a piece, and $10 charged for the cups in which medicine pills are served.

"Don't charge me $9000 a day for an (intensive care) room and then charge me for the gown I put on, the socks I put on," said Palmer. "You can't have it both ways."

Patients normally just receive a summary bill from their provider.  Palmer says if you have questions you should ask for it to be unbundled.  She says you are entitled by law to get an itemized accounting of all your charges.

"They're not going to voluntarily hand you this," said Palmer. "Because everybody would be complaining."

She says the next step is to challenge in writing all the items you are disputing.  The hospital has to respond to you in writing.

"There's nothing they can give you to support charging you for sheets and gowns and teddy bears," said Palmer.

Palmer says you should also make a challenge anytime your insurance denies a charge.  She also suggests you ask questions if you receive bills after paying co-pays and deductibles. Palmer says your insurance company pays the provider a negotiated, discounted price.

"If they are participating with that insurance they should not bill you above what the insurance allows," said Palmer.  "It has to be written off."

Click the video icon to the right to see more of the interview with Pat Palmer.

Medical Billing Advocates of America is a for-profit company.  It works with individuals and businesses looking to curb medical costs.  It typically charges a percentage of the realized savings.

As for the Alexanders, it doesn't appear they were overcharged.  But getting the hospital to understand the mistake and move the money to the proper account, to call off the bill collector proved to be the challenge.

"We regret she received that response," said Tate Batson of Presbyterian Hospital. "We could have moved that money to where she would have liked for it to have gone."

Presbyterian says the account has now been settled and the bill collectors have been called off.

"Hallelujah," said Alexander. "I knew I wasn't losing my mind."

Presbyterian Hospital Patient Assistance

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