While most people have read about the extreme markups for common items ($7.00 for two Tylenol; $30 for a “thermal therapy kit” which was just a bag of ice; $20.00 for a box of facial tissues), that has not shamed the hospitals into stopping this practice. Outrageous markups for common items are a continuing problem in hospital bills. Such overblown charges should be questioned.
A less obvious inflated charge comes from a practice called “unbundling.” Hospitals are required by the laws establishing Medicare to “bundle together” all the related costs associated with an operation. So for a surgery to remove someone’s tonsils, the cost of all other goods and services (like blankets, nursing staff, etc.) the cost of all of the equipment used, and the cost of using the operating room itself must all be included in the one surgery charge. Charges must be examined carefully to be certain bundled services provided with a surgical procedure are not also separately billed.
Another version of unbundling occurs when there is a general charge on the hospital’s bill described as “room and board” or “room kit” or “room tray” but then there are also specific charges for items like toilet paper, facial tissue, soap, shampoo or toothbrushes.
Inflated charges can also occur by coding errors by the hospital or doctor’s staff. This occurs when a similar but more expensive procedure or service is mistakenly billed. This use of the wrong Diagnostic Related Grouping (DRG) can result in a higher bill. The doctor’s records are more likely to reflect the actual services performed and hospital bills and doctor’s records must be reviewed with this in mind.
Our office is expert at helping find insurance to pay these bills, or at negotiating a reduction in proper cases where there is inadequate insurance.
Please call us today at 916.921.6400 or toll-free at 1.800.404.5400, or use our online contact form for a free consultation.