Medical billing is one of the industry’s biggest problems. Many Chicagoan’s are overpaying on their hospital bills and do not even know it. They could be receiving two or three times as much as they need for the services rendered.
Overbilling is an intentional and unintentional act by the provider, hospital or billing coordinator, which can be outsourced. Most people in America have at least halfway decent health insurance provided by their employer. In many cases, the employer sponsors plan pays most of the bills and the patient is only left with a reasonable portion. For the most part people will forget about it until the 2nd, 3rd or final notice comes. One reason for this is most of us are procrastinators. Another reason could be is that they want to know what they need to pay, so they wait until the final bills are issued.
There is a problem with this process. One or two bills could be easy to track. Once the medical bills start piling up, it can be harder to figure out how all the pieces are fitting together. Once someone is overwhelmed with the process, it can be hard to trace it back and match all of the bills up.
It is common for insurance companies to send out what is called Explanation of Benefits, or known as EOBs. EOBs are statements provided by the insurance company so the patient can track what is being billed to the carrier to apply towards the policy’s benefits. This document will reference items, which can differ from company to company. The most common items are:
* Amount billed
* Eligible charges
* Network discounts (if any)
* Applicable co-pays
* How much applied to deductible and/or co-insurance
* Check information if benefits were paid for by the carrier
This is a list of only the common items. The policy holder’s carrier may personalize it with additional information that may not be included with the above information. The patient should now cross reference the information with the bills received by the providers and/or hospital. There could be possible surprises here. Here are a couple of questions you should ask yourself when cross referencing these bills:
* How many doctors did you see during what time frame?
* Did you even consult with the provider that is billing you?
* Where they In or out of network?
* Did you receive all the supplies being billed on the invoice?
* Where you even at the location given on the invoice?
* Did you even have a Private room?
* Did your insurance company even receive this bill?
The list of questions can go on. Hopefully, the list will trigger additional questions while you are auditing the bills. A little due diligence can go a long way. This can amount to savings that can add up to thousands of dollars either for you or the current insurance carrier. It’s obvious that it will be a positive impact for you, the policy holder, if you are the one saving hundreds, if not thousands, of dollars. How about the impact on the industry if even one thousand patients saved the insurance carriers thousands of dollars? What would it do if a couple hundred thousand patients did the same thing that amounted to millions of dollars from over billing?