Medical bill errors are common and can be costly. Roughly 8% of medical bills have an error (source), yet insurance companies often don’t find these errors. Efficiency is key to the insurance business, and finding and fixing errors on the medical bills themselves is neither quick, easy, nor profitable.
If insurance companies aren’t finding errors, are the patients responsible for identifying them? After all, the medical bill should reflect what happened between patient and provider.
Aside from the providers, the patients are the only people who really know what happened in their examination rooms. To be fair, patients do find a small percentage of errors, especially if it impacts their bottom line. However, patients can’t be expected to catch all the errors especially since our entire healthcare system and how we pay for it is so complicated.
Have you really looked at a medical bill lately? There’s typically not enough information there to identify if there was an error. They’re the equivalent of a restaurant check saying “Dinner… $79.23.” You’d have no idea if the server accidentally charged you for an extra beverage or the wrong entree. Compound this with the fact that patients don’t have an expectation for what their medical bill should cost because they haven’t even seen the price on the menu, so to speak. While you may know your copay amount, do you have any idea what the components of the office visit cost? The answer is probably “no,” and as long as you are charged the correct copay, most people probably don’t care. But what happens when you are responsible to pay for a for more of that bill, whether it is part of the deductible, your copay, or for some reason you insurance company has decided it’s not their responsibility, but yours. Now all of a sudden you really should care.
Requesting an itemized bill is the first step. However, it’s time-consuming and unpleasant to request one, and requires the patient to be interested in jumping through extra hoops. Once you have an itemized bill you need to know what to look for and how communicate with the providers and your insurance company to fix it.
Athos is a personal guide for you and your members on their healthcare journey. We experts in how the system works and understand where people get lost. We can protect you and your members from overpaying on their care with personalized advocacy programs. We have over 25+ years of experience in the healthcare industry and we know how to save you money.
Let us jump through the hoops for you and your members, saving time, stress, and money. It’s time to have someone on your side.