WARNING: Long post. Self-serving and defensive. Please have mercy!!
I share with many a sense of anger and frustration with healthcare costs. I also know and deal with many healthcare providers, insurance companies, and facilities on a daily basis. I've unfortunately had significant recent healthcare costs myself, with billing and insurance errors I had to dissect to correct. Perhaps I'm overly defensive here, and I expect I'll be bashed soundly, but here goes: I have very very rarely encountered anything but a well-mannered response and good efforts on the part of those players to correct errors (as long as I tried to keep my own cool). I have seen errors (some human, some a function of "systems"). I have never encountered intentional fraud. I have made such errors myself: I don't steal from people, or "systems", and I truly appreciate it when any billing error I have made is brought to my attention to correct. This has been my experience with every healthcare provider I have worked with, also. So we're not all crooked or unconcerned about these issues. We're people just like everyone who reads this forum. There are many of us ON this forum.
An example: Twice in the last three weeks I was angrily contacted by a patient of mine (two different patients) who were venomously enraged at what they felt were excessive and unfair charges from a doctor to whom I had referred them (two different doctors). Yet, the patients were wrong in both cases. In one case the doctor's office had noticed the error, corrected and credited the patient's credit card charge, and sent a letter of appology to the patient. In the second case the office did the same, but the doctor personally called the patient to appologize and offered to see them at NO CHARGE for the office visit the patient didn't get. They did this unprompted by me, before I even contacted them, and (more important) before either patient had even mentioned to them the error. .
[O.K. Naro....stop being so defensive!]
I've cut and pasted some of the comments and suggestions, and added my thoughts FWIW:
"to check for particular items on the bills, such as procedures that weren't done, meds that weren't given, etc. He said to look for typos, like an extra zero (i.e., $80 medication that they are charging $800 for), or multiple entries for the same thing.....just google ICD9 .....I can comfortably state close to 10% of those bills are bogus. Whatever the reason, fraud, typo, honest mistake."
I've been happier with the outcome when I start with the assumption of a "typo..or honest mistake".When I didn't understand the code or terminology, the insurance company or facility billing office politely explained it to me. I have never had a problem getting such errors corrected. Perhaps I've been truly lucky.
"if the wrong thing has been typed in, or the wrong code used, your insurance company will AUTOMATICALLY not pay it, and that part of the bill is passed on to you"
Not in my experience. Particularly if you are on a PPO or other "panel". If the wrong thing has been typed in and the insurance company disallows the charge, they are just as apt to deny the facility/doctor the ability to "balance bill" and typically that means that the charge CAN NOT be passed on to the patient. I also see insurance companies paying for these errors when they should NOT have. When I've been civil (sadly, not always my first manner) the error was corrected: but it can take a few "billing cycles" to do this and meanwhile each bill I got ticked me off anew.
"we had a $4 bottle of 200 in her suitcase that we brought with us.... bring your own meds with you"
Can you imagine a patient bringing their own pills... but being mistaken about what the medication was or how it was to be taken? It absolutely happens, even with simple drugs like Motrin. The way to handle this is to have the physician write an order permitting the patient to take his/her own meds., which most physicians will do (after hopefully looking at the meds. to confirm). But the nurses or the hospital shouldn't take the authority to do this. Your doctor should.
"getting a bill for $400 from a doctor who looked at your chart at the nurses station while you were asleep and billed you a full consult after scanning the pages, is criminal"
Is it criminal? What are the specifics? Believe it or not there are many circumstances and medical specialists in which the "consult" does not require examining the patient. Perhaps it would be courteous to do so even if not medically necessary. I have had circumstances myself in which everything I needed to render a competent consultation was in the chart, and to even talk with the patient was inappropriate. So I can't go along with the blanket assumptions in the post without some details.
"Her own doctor sent a bill to the estate for a hospital visit and exam... for the day AFTER she died."
I once billed a deceased patient for a visit which on the bill was dated after she died. I was mortified! I posted the wrong date. I saw her before she died. In fact, had I known she died, I wouldn't have sent the bill in the aftermath anyway. But my error was in a digit on a billing slip. Might we start by assuming the same about the doctor referenced above...give him/her the opportunity to correct a possible error... before reaching any conclusions?
O.K....I'm braced. Beat me up.