One of the worst things to deal with in the modern medical industry is billing errors, which are costing people billions every year. However, there is a new web-based service called Simplee which is one of a number of services out to cut down on such errors.
Killing ourselves to stay alive
Medicine is a business and hospitals, doctors, nurses and gift shop attendants certainly have a right to earn a living. However, one of the most daunting parts of the patient experience is getting the bill.
Aside from already high costs of medical care, consumers are also being dinged by medical billing errors. Estimates range as to how common they are. The Medical Billing Advocates of America, according to USA Today, believes 8 out of 10 medical bills have errors. Health finance professor Stephen Parente of the University of Minnesota estimates it’s between 30 to 40 percent.
These errors are hurting people. According to the Wall Street Journal, the Commonwealth Fund estimates credit reports for 14 million people have been hurt by medical billing errors. The Federal Reserve estimated in 2010 that half of all bills in collections were medical.
Doing something about it
Not every error is deliberate. Some are honest mistakes, but some are egregious. Parente found in his study of billing errors, according to the Cleveland Plain Dealer, that only 15 percent of errors were down to “waste, fraud and abuse.” Medical fraud, though, accounts for up to $68 billion in waste per year, according to USA Today.
However, there are some things people can do about it. Medical billing advocates, who review bills given to patients and also claims submitted to insurance companies, can go over a person’s bills and Explanation Of Benefits forms from insurance companies.
There is also a new web-based service called Simplee that will do the review automatically. Users submit the necessary records to Simplee, which has an algorithm for checking for errors automatically. If an error turns up, Simplee will alert the user to the error. The best part is that Simplee is completely free for the average person. Health plan administrators, insurance companies and businesses offering health care to employees, however, can subscribe to use Simplee as an auditor.
Take nothing lying down
There are a few things people should always bear in mind if dealing with medical errors. Medical bills are one of the most common things people get short term loans to pay off and there is no reason to pay a bigger bill than one should.
First, according to Consumer Reports, ask for an itemized bill. Then call the billing department at the hospital or clinic and ask what each service costs; if they quote it for less than they billed for it, that’s an error. Don’t hesitate to ask for the UBO4, the claims form submitted to insurers.
Try to log every treatment received and look for any procedures and medications that were never delivered. Ask for the medical records to double-check. Also log the time at check-in or admittance as well as the time at discharge, to guard against being billed for time not spent at a hospital.
Don’t be afraid to call a medical billing advocate. Many work on commission and won’t charge a dime if there’s no billing reduction, so there won’t be anything to lose but a discount.
Consumer Reports: http://www.consumerreports.org/health/insurance/health-insurance/make-your-insurance-work-for-you/medical-bills.htm