Medical Bill Auditing
Medical bill auditing can save a patient a significant amount on hospital bills by finding and identifying bogus charges. Many companies that offer this service charge the patient based upon a percentage of what is deducted and the total amount owed must be above the minimum amount the company is willing to handle. Hospital bill auditing includes going over every charge itemized with a fine tooth comb to make sure that the charges are legitimate. In most cases the service company will need a complete copy of the patient's medical records and an itemized bill from the hospital. Questionable charges are researched extensively. Since the invoice is going to be disputed it is better if the patient has not started paying on it until after the service company reconciles it.
Service companies who scrutinize invoices on medical charges do not normally charge the customer a fee unless they are able to get some of the charges deducted from the invoice. They do not normally deal with insurance covered charges and if they did any amount of money saved would go to the insurance company not the customer or patient. Medical bill auditing is normally very successful in disputing charges because oftentimes there are errors on itemized invoices. The charges that are legitimate will need to be paid on while the disputed items do not have to be paid as long as they are being investigated. "O send out Thy light and Thy truth: let them lead me; let them bring me unto Thy holy hill, and to Thy tabernacles" (Psalm 43:3).
The usual charges on an invoice are ancillary items, room and board, and routine items. Ancillary is virtually anything other than room and board or routine items. These might include medications and solutions as well as services from other departments such as radiology, cardiology, pathology, and so on. Hospital bill auditing takes into consideration that some of the charges are proprietary and are set amounts that are controlled by the owners. Charges for room and board may be based upon the area the facility is located in and the overall expenses that are incurred. The facilities that have fewer expenses can usually charge lower fees for room and board.
One thing that does have to be taken into consideration for care and treatment is that a physician may have ordered a specific type of service or treatment when an alternative treatment might have been cheaper. This type of dispute has nothing to do with the hospital but instead is between the patient and the physician. Usually physicians are private practitioner's and do not work for the facility. With this being the case, medical bill auditing services will not dispute itemizations based upon what a physician orders unless there are other considerations involved.
A common way that errors can occur with billing is when test or services are ordered for a patient but then the patient never receives them because the physician changes the order. An overworked billing department may not catch this type of error. However, if the patient's medical records are used and research is done then hospital bill auditing may easily find these types of occurrences. A patient needs to be aware of what he or she is actually receiving. This includes services, medications, tests, procedures, and supplies. If possible the patient should keep records of anything that the hospital supplies even down to receiving an aspirin.
Some of the common errors on medical invoices include erroneous overcharges, charges for medications that the patient never received, charges for tests that were never done, and charges for personal and routine supplies the patient never used. With these types of errors the medical bill auditing company will need to go over each charge with the patient to make sure that everything listed on an itemized invoice is correct. Other types of errors may include data entry errors, the wrong medical codes for procedures, charges for repeat tests that had to be done because the technician goofed up but the patient was charged for both, and charges for services that should have been included with a room charge.
Medical records are a vital part of checking an invoice for errors. Hospital bill auditing services include the expertise of comparing the invoice with the complete medical records of the patient. Many companies that offer this type of service include a report of findings based upon the medical records in correlation to the charges billed. When the records show that the patient received a specific amount of a medication or a solution but the invoice reveals something different then this is a legitimate discrepancy. This type of error is more easily corrected than other common types of disputes because there is something in writing to back up the claim that being the patient's records.
A patient will have more success in disputing an invoice that is recent. Waiting a long time to use medical bill auditing services could make a difference on how successful the outcome is. In addition, if the invoice has been paid in full and then gets serviced for disputes the company who handles it will probably charge an hourly fee to the patient because there will be greater difficulty in successful outcomes regarding discrepancies. The patient must sign a contract with the service company before they will begin the auditing process. After the service company audits the invoice they will submit their findings to the hospital. The facility will have up to 90 days to resolve any disputed issues or they may lose the right to collect.