I-Team: Fighting Bogus Bills

Patient advocates tell News 2, some 80 percent of medical bills contain bogus charges, and those errors cost billions every year.

Our I-Team found some of the most common errors included charges for procedures you never had, duplicate charges for a bill you already paid, and charges for medication or quantities of it you didn’t receive.

“People think it’s an isolated case, it’s not,” Pat Palmer told News 2’s Rebecca Collett. “It’s happening across the nation.”

Palmer is a patient advocate who helps resolve issues on medical bills. She says errors happen on four out of five bills

News 2 requested complaints from the Department of Consumer Affairs. We found patients who lodged complaints against several area hospitals and doctors’ offices.  One patient found a bill that was never submitted to insurance.  Another identified additional charges for bills that were already paid. There were over payments and excessive charges not quoted upfront.

But Palmer says the errors aren’t obvious on the summary bill you get in the mail.  She warns patients to request the itemized bill from your provider before paying charges on the summary bill.

“An itemized bill will let you know each and every item,” she explained.  “Then you have something we can begin to analyze.”

While parts of the bill may be confusing, you can easily determine if you’ve been charged for the wrong medication or quantities of it. Also, look for errors with services or lab work you didn’t receive.

You can start resolving the issue by calling the billing department, and if you can’t get help with them there is free help offered by the South Carolina Department of Consumer Affairs.

“It’s a free service and you can’t lose anything by doing it,” the Department’s spokesperson, Juliana Harris, told News 2’s Rebecca Collett.

The Department fields nearly 5,000 complaints every year on a variety of industries. Harris said resolution generally takes 20 to 25 days.  The Department saved South Carolinians $1.3 million in credits, refunds, and adjustments.

Filing a complaint can help you and others.

“We use complaints to help identify trends,” Harris explained.

You can also get help from a third party patient advocate like Palmer.  Generally, you pay a percentage of the money they save you.

“Health insurers and providers have a responsibility to ensure that claims for covered benefits are paid,” spokesperson at Blue Cross Blue Shield of SC, Patti Embry-Tautenhan, told News 2. “Consumers have a responsibility to be informed.”

She recommends the following steps for customers:

  1. Make sure that all your information is up-to-date for both your health insurer and your provider.
  2. Review your policy so that you understand your health insurance benefits. Know your deductibles and co-pays.
  3. Review your explanation of benefits (EOB) for any discrepancies. It explains what services you have received and what is being paid.
  4. Keep your documentation so that you have access to the information if you have questions.
  5. If you believe that there has been a mistake, call your insurer’s customer service line (the number is on the back of the insurance card), the hospital billing office (the number should be on the hospital bill), and the doctor’s office.
  6. If you still believe that a claim should be paid, members have the right to appeal.

To Resolve issues at local hospitals:

Roper Hospitals:
Call:  (888) 888-7010.

MUSC:
http://www.muschealth.org/patients-visitors/billing/financial-assistance.html
http://www.muschealth.org/patients-visitors/billing/faq.html
http://www.muschealth.org/patients-visitors/billing/payment-options.html

Trident:
Call:  (866) 492-9085
Counselors are available by phone or walk-in appointment Monday through Friday from 8 a.m. – 4:30 p.m.

  • Yena Logan-O’Neal – 843-847-4038
  • Hope Smith – 843-847-4133
  • Krysti Baumgarner – 843-847-4047
  • Jennifer Melton  – 843-847-3212

East Cooper:
Call: (843) 416-6099.
https://www.eastcoopermedctr.com/for-patients/i-am-a-past-patient/billing-and-insurance-questions

 

 

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