Content Overview
- Summary
- Why Review Your Hospital Bill
- When I Look At A Hospital Bill, Where Do I Start?
- Terminology To Look For In A Hospital Bill
- What Should I Do After I Discover Errors In My Hospital Bill?
- Insureds With Bills For Care Provided In The Hospital By Doctors Who Are Not In The Plan's Network Or Whose Services Are Not Pre-Approved
- If You Need Help Reviewing A Hospital Bill: Professional Claims Assistance
How To Review A Hospital Bill And What To Do If You Find An Error
What Should I Do After I Discover Errors In My Hospital Bill?
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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which accredits hospitals, requires that every hospital have a mechanism in place for dealing with billing disputes.
- Put your concerns in writing and attach specific documentation for the suggested corrections.
- Call the billing department and get the name of the head of the department.
- Write a letter to the department head describing the mistakes. Ask for a corrected bill within 30 days. Mail the letter in a manner which provides a receipt (such as certified mail, return receipt requested.) If you are insured through a private company or Medicare, send the insurer a copy of the letter. Keep a copy with your files.
- If you are not happy with the response, contact the hospital administrator's office.
- If you are still not happy with the response, request a "utilization review" from your insurer for an in-depth accounting of your hospital stay.
- Do not be intimidated if the hospital suggests that in order to review a particular charge, it will require an audit of the entire bill - and then goes on to tell you that an audit may result in an even larger bill. Audits usually work in the patient's favor.
- If you receive no satisfaction, contact the consumer protection office of your state's Attorney General. You can find the phone number at the National Association of Attorneys General: www.naag.org
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