93% of Americans find reading a hospital bill more difficult than reading a book in a foreign language. Actually, we made that stat up, but most people agree that understanding medical bills is challenging, stressful and time-consuming. Without getting into the many reasons why hospital bills are so confusing (we’ll save that for another blog post), TouchCare wants people to know that there are things you can do to cut through the confusion and make sure you don’t overpay. As a dedicated advocate with medical billing experts on staff, we’ve seen it all. Here are some of the frightening realities of hospital billing and ways in which everyday consumers fall victim to the over-complicated system.
Surprise Medical Bills:
Most commonly, surprise medical bills occur when a procedure is performed at an in-network facility by a doctor who is considered out-of-network by your insurance. Believe it or not, 1 in 6 hospital patients get a surprise medical bill. Planning for a healthcare procedure - major or minor - can be stressful. As a consumer, you can do almost everything right and still end up with a surprise bill if you’re not extraordinarily careful in your planning. That can be both overwhelming and time-consuming. TouchCare’s procedure planning services ensure that surprise bills don’t happen. We’ll make sure the facility, the doctor, the anesthesiologist, and the equipment used are all covered by your insurance. And on the back end, we’ll make sure the bills are correct. Which brings us to….
Incorrect Billing Codes:
Healthcare providers use a series of codes known as ICD codes for their billing practices. These codes dictate the levels of discount, coverage, and reimbursement for procedures performed by the provider. Consumers are left to pay whatever the insurance companies don’t cover and, when you receive a bill, it can look like a dinner menu written in a foreign language. As such, many healthcare providers take advantage of fraudulent billing practices by unbundling procedure codes so they can bill more. Another common practice is to abuse the codes by over-billing (think about a quick five-minute appointment with a doctor that is then billed as a 45-minute visit). There are online tools that consumers can use to try and better understand their bill themselves, but TouchCare has billing experts on staff who understand and review both the coding system and the billing practices of providers and insurance companies.
Medically Unnecessary:
Depending on your insurance coverage, you may not have coverage for items that are considered “medically unnecessary.” Fraudulent billing practices can occur l when providers perform procedures or administer treatments that are not medically necessary. Many times, the pharmaceutical or device companies will pay doctors large kickbacks to use their products. Unfortunately, this puts consumers at risk. By having TouchCare review your bill, we will ensure that you are not paying for any services that were medically unnecessary.