Knowing This Hospital Scam Could Save You Thousands of Dollars
- Author: William Asher
- Posted: 2024-08-01
Of course, nobody likes going to the hospital, but it's a necessity for most at some point in their lives. While the United States has a variety of private insurances and offers public health insurance for those who are impoverished and disabled, more often than not, hospital patients are left with a fat bill. However, more and more states are catching on to the fact that billing departments at some hospitals are unscrupulous.
Here's a common hospital scam that's emerged recently, how to combat it, and other tips to lower your bill. Remember, a penny saved is a penny earned, especially when it comes to huge ER bills!
The Out of Network Scam
When you go to a hospital, chances are that you'll need to have some tests or imaging done. One variant of this scam is called "surprise billing" under new legislature in many states. This means that, even if you go to a hospital in your network, your provider may be out of network. This used to simply be an issue that was out of people's control.
After a visit, you'll likely get several bills in the mail. It can be painstakingly slow, but take time to ensure you understand all charges you incurred. Hospitals often use out of network providers with the hopes of you not noticing it. If you're in a state with a "surprise billing" law and are assigned an out of network provider outside the provisions of the law, you likely won't have to pay that bill! Remember, though, that you can't simply ignore it. You'll need to come to an official resolution.
Lab Tests and Imaging
Unfortunately, this form of scam is fairly common. Not only do you have to worry about hospitals billing you for an out of network provider that you didn't request, but you also have to be on the lookout for out of network interpreters.
When you get a lab test or image study done, you'll need to pay the hospital for using the machine. However, your test results must be determined by someone trained in that field. Some hospitals have an in-network doctor on-site who interprets your results. However, especially in smaller hospitals, this is usually not the case. They tend to contract with remote providers who receive the image and determine your results.
Most "surprise billing" laws also cover this practice. Although hospitals will try to bill you whatever they can, you can usually get out of paying for out of network tests, especially if you weren't informed that they were out of network.
The Double Billing Scam
On a related note, hospitals sometimes partake in "double-billing". This is often done when a patient has an interpretation done as mentioned above. The hospital will bill the patient for the full service as if they were in-network, but then they will not use that money to pay the out of network provider who actually renders the service.
This will result in you getting a bill in the mail for the full service from an out of network provider. Most of us don't have enough time to go through every bill meticulously, but this is one of the situations where setting aside ten minutes could save thousands of dollars. In this case, you should call your insurance company to inform them, not the hospital. After calling the insurance company, you should call the third party to explain what happened. After doing that, you should call the hospital and request a refund.
The Moral of the Story
So, what is the major takeaway here? First, you should not trust hospitals' billing departments. They are not there to save you money. Even if you have the best insurance possible, they will likely not be of much help before you do your own digging into the issue, unfortunately.
Every time you receive a bill, make sure you get a fully itemized copy of it. Some states require this by default; others require it upon request. Seeing the itemization can help highlight what the major contributors to your cost were. If you don't understand anything on the bill, simply call your insurance company! You pay good money for the services they provide, so it's only fair to lean on them in tough hospital billing situations.
