Don’t skip the details: What to look for in your medical bills

Don’t skip the details: What to look for in your medical bills

Ugh! The inexplicable columns of letters and numbers listed on medical bills. It’s no wonder why many consumers ditch their billing statements and insurers’ explanation of benefits after scanning them to see what they owe.

But as the saying goes, “The devil is in the details,” and the details could cost you. Use these clues to decipher your medical bills to save yourself some money, aggravation and misinformed medical care.

  • Does the bill belong to you? Check the name, address and other identifying information.
  • Did you get an itemized statement? If not, request one.
  • Did you get billed by more than one provider for a single procedure or hospital visit? Find out who the providers are, what service they provided, where and when. It’s possible you were billed twice for the same procedure, or even for another patient’s treatment.
  • Are you getting multiple bills from your providers? If you see multiple providers or get service from multiple departments in a hospital, for example, ask them to combine your bills to help you keep track of what’s charged and paid by you or your insurer.
  • Is the service you received described accurately? Make sure. If a description isn’t provided, find out the meaning of the medical code your doctor or specialist used to bill you by searching the American Medical Association’s CPT Code/Relative Value search page. You can learn the meaning of International Classification of Diseases (ICD) codes hospitals use by contacting the hospital or your insurer’s member services department.
  • When did you see the provider and how many treatments did you receive? Verify that the date of service and units (the number of times something occurs, like a doctor’s visit or lab tests) received are correct.
  • What information did the provider give the insurer? Compare and match all bills and charges with the information on your insurer’s explanation of benefits.

Related: Cracking the codes on your medical bills

Related: How to dispute a medical bill

Sources: Warner Medical Billing Consultants, Oregon Imaging, Medical Bill & Claim Resolution, American Medical Association


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A hospital visit can end with medical bills from a number of different providers, including some you don't owe.   
(Illustration by Mike Lester)
A hospital visit can end with medical bills from a number of different providers, including some you don't owe. (Illustration by Mike Lester)

Do you understand your medical bills? Learn how to read CPT and ICD billing codes so you'll know what they mean and if you’re being overcharged for health care.

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Dennis Timko

Subject: Medical bill charges

Interesting articles, but it think you left out a very important part on explaining what charges mean versus allowed amount. Every patient in my practice that complains about a bill always states their charge and that we are over charging, but fail to look at the allowed amount and adjustment to see how much they are really saving and truly owed. Most people now a days with these higher deductibles are stuck with the bill so I see more complaints and more collection statements because people don't want to pay. It always hurts the doctors and never the insurance companies, who ultimately is there fault.

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