Understanding your medical bills isn’t so easy as it seems. Because it contains particular healthcare terminologies, confusing acronyms, and complicated medical codes. So, patients may find it difficult to read and understand their hospital bills.
It is crucial for patients to read the bill carefully. Because it has been estimated that about half of all medical bills contain incorrect charges or surprise fees.
It is possible that hospitals may charge you for the wrong or twice for the same service either intentionally or unintentionally. When you will understand your hospital bill, you can easily take action in case of surprise billing. So, in order to avoid any inconvenience, it’s crucial to scrutinize your bills. You must understand the fact spotting an error can save you thousands of dollars.
What a Medical Bill Really Covers?
A medical bill usually contains the following information:
- Statement Date: The date on which a bill was printed.
- Service Date: A column listing the dates you received each medical service.
- Charges: This is the full price of the medical services or supplies before the implementation of insurance coverage.
- Billed Charges: It is the total amount that directly charged you or the payers.
- Insurance Payments: The amount that has been already paid by the insurance company.
- Copays or deductibles.
- Payable to: Where (or to whom) payment should be submitted.
- Unique Account Number: You must provide this number when contacting your healthcare provider’s billing office, and while paying online.
Tips to Understand Your Bills
If you are looking for easy ways to read and understand your medical bills, then your search ends here. In this article, I have mentioned some tips to help you understand your health insurance bills. Which enables you to identify the errors or other issues.
1. Check the Basics
First of all, you should check the accuracy of your personal information including name, address, date of birth. Then you must verify your health insurance information, including, policy number and group number. Because a slight error can lead to the claim denials.
After verifying the basic information, you should carefully check the dates of your hospital visit as listed on the bill. Moreover, If your bill does not contain a detailed list of charges, then you should ask the physicians to send an itemized invoice. By doing so, you will get an idea of whether you charged for the actual medical services or not.
2. Understand the Codes
Medical codes describe the patients’ diagnoses, treatments, procedures, and equipment. Therefore, patients must understand these codes to get detailed information about their diagnosis and they can figure out how much their physicians were paid.
Several types of code sets are used for different purposes during this process, including:
CPT codes
The Current Procedural Terminology (CPT) coding system is used to describe the services such as: tests, surgeries, evaluations, and any other medical procedures that a physician provides to a patient.
ICD-10
International Classification of Diseases (ICD-10) contains codes for diseases, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.
If your bills contain a confusing medical code, you can type the code into Google to get a better idea about the medical charges. Moreover, you need to carefully check for the following coding errors that might happen with the coding on your medical bill:
Unbundling
It refers to using multiple CPT codes for a group of services or supplies that get bundled together.
Upcoding
It occurs when a person is billed for a more expensive medical service or procedure than the one that was performed.
Under-coding
Under-coding might occur when medical coders fail to capture all work performed. It is a fraudulent activity that can be intentional to avoid an audit.
3. Compare with your EOB
An explanation of benefits (EOB) is actually a report from the insurance companies. That describes what services a medical provider charged your insurance carriers. And what part of that charges your insurance company paid.
You can compare the EOB with the medical bills to ensure that the dates and codes are the same on both documents.
4. A Quick Accuracy Check
You should carefully check the most frequent billing mistakes such as:
- Look for duplicate charges for services you only received once.
- Make sure the ICD-10 codes refer to the reason you were in the hospital. If you see an ICD-10 code that doesn’t match the right condition, you should immediately contact your healthcare providers.
- Moreover, carefully check your medical bill to ensure that you aren’t billed for any medications, you didn’t purchase from the hospital.
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