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rbekins t1_iuipjz7 wrote

The key point of this article is that the patient in the article's wife is the manager of a medical office and her duties include billing. In other words she has knowledge of medical billing.

Following tip 2 getting an itemized bill will not get the average person the same result. The average person will not understand a detailed medical bill, this is even stated in what a term or code means, knowing whether or not that was performed.

Nor will following tip 3 comparing your charges to those at other hospitals work like comparing gas prices at nearby stations, hospitals don't compete like gas stations. Depending on the area you are there may or may not be multiple hospitals in your immediate area and those hospitals may be different sizes all affecting what they charge. Hospitals also have negotiated contracts with each insurance carrier that affects what you pay, some insurance companies get better/worse deals than others.

Again, the key point of the article should be if someone wants to investigate their medical bill, not requesting an itemized bill, or comparing prices, but having knowledge of medical billing.

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shadow_chance t1_iuj4116 wrote

I think the real key point is that the service in question truly never happened and was the wrong CPT code. Of course, her knowledge played a role.

Most of the posts here about "get the itemized bill" think that there's just going to be line after line of phantom services. $5000 drugs you never received. $50,000 MRIs when you never stepped foot in a scanner.

90% of the time (ok maybe less), the bill is accurate, just expensive.

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11ej25 t1_iuj8s92 wrote

I could already imagine the insurance saying "well splinting is treatment" and then just hanging up

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nn123654 t1_iuj3iio wrote

Also even if you want to understand, the CPT coding books are behind a pretty substantial paywall. It's like $150 for a copy of the latest reference book. You might get someone to explain it to you, your best bet would probably be to call your insurance company and ask them to explain your bill, followed by the department's billing office. I say this because trusting the provider to check the bill is a conflict of interest.

As for insurance price comparison, most insurer websites I've used in the last 5 years have had some kind of feature to compare average prices with that insurer. It's worth knowing for the hospitals around you. But even if you do with medicine it's difficult to know what services you're going to need, the treatment plan may change dramatically after diagnosis. For instance you may think you are going into the hospital for some foot pain, find out you broke your foot, and come out with a cast and crutches.

One big tip: do not go to the ER unless it's a life threatening emergency (chest pain, stroke symptoms (slurred speech, sudden loss of balance, drooping face, confusion, trouble seeing), late pregnancy complications, blurred vision, trauma, severe burns, etc.). Urgent care facilities are about 1/5th the cost of the ER. If you set foot in the ER you can usually expect it to be at least a $2,000 bill and how much you have to pay will vary greatly based on your insurance coverage.

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Engineer-Daddy t1_iuik4dv wrote

Most people can knock thousands off the charge just by calling up and making payment arrangements...

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nn123654 t1_iuj011b wrote

Lots of hospitals will offer prompt payment discounts or will even reduce the bill if you agree to go on a payment plan instead of it going to collections.

I would still start with an itemized bill and make sure each charge is correct before I did this though. Then you should be able to stack the payment discounts on top of this.

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ElementPlanet t1_iuj3mx9 wrote

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