Read Medical Bill Like A Pro

Hospitals nowadays use advanced technologies and methods to make their cash flow organized. These tactics not only help hospitals but also patients to make them comprehend the health services and their costs, especially for those who are covered by insurance plans. One of the approaches used by health practices is to provide patients with advanced medical bills.

A medical bill may be seen as a simple bill, but its detailing might be confusing. There are a number of difficult terms used in the bill. But how can you read a medical bill? After consuming our guide you will be able to understand the bill received in return for your health service. That will help you better have an idea about your services and charges.

Is Medical Bill Different From Explanation Of Benefits (EOB)

Many patients resemble EOB with a medical bill and take both as the same thing, but in reality, it isn’t. Medical bills list all of the services taken by the patient along with their costs and present the final balance that you owe to the hospital. Whereas an EOB is a document that describes the amount paid for each service by your insurance company and what are the services that are not paid for yet.

While medical bills and EOB indicate different charges, it is a good idea to get both in hand. As, when the charges mentioned in the medical bill seem very high, you can get help from EOB and analyze what services your insurance covered, and what is the remaining cost that you owe. It helps verify the bill and your charges as a whole.

Cycle Of A Medical Bill

If you are new to medical billing or want to make your health payment processes efficient, you might not know how a medical bill is generated by the hospital. Let us tell you. 

First, you have to book an appointment at the hospital. During the booking procedure, hospital staff will ask for your details and necessary information which is kept recorded in their systems. 

While hospitals perform their work, you too have to do homework and that is to ask for the expected service charges you’ll have to pay to the hospital. Asking for the bill in advance may save you from a number of difficulties. You can better analyze whether your service is covered in your insurance plan or not. If any health service doesn’t come under your insurance package, contact your insurance payer and ask if there is any payment plan that will lessen your burden to pay the bill.

However, when you go to the hospital for treatment, the staff asks for further information. The treatment begins, after the completion of which the hospital staff captures codes for each health service. Then they prepare a claim application to get their reimbursement. 

Claim application contains codes that are identified by the insurance companies. Then, after verifying the application they contact the hospital and convey the message of whether the claim is approved or rejected. If the claim is accepted, hospitals get the insurance payment and they create a medical bill containing charges you owe, which you are required to pay under a specific deadline.

Reading The Bill

Once you receive the bill, you may find most of the mentioned information puzzling. To understand the medical bill, you must know the significance and objective of each detail:

Statement Date

It is the date on which your bill is printed by the hospital.

Account Number

This is your personal account number that you have to give to the billing office. It mostly facilitates when you pay the bill online.

Service Date

There is a column in the bill stating all the dates on which you took each health service.

Description

This phrase explains each service and supply you were given.

Charges

This is the total price of your health services including supplies, excluding insurance coverage.

Billed Charges

These are the charges that you or your insurance payer owe.

Adjustment

These charges are the ones that either your insurance payer has negotiated with the hospital or either hospital themselves decide not to charge.

Insurance payment

As the name indicates, it is the amount that your insurance payer has paid.

Balance

This is the actual amount that you have to pay.

Payable To

It is the institution that you have to pay the check.

Besides all this, a service code is also mentioned in your bill. It is the identification of each diagnosis taken by the patient and helps hospitals differentiate multiple services.

What To Check On The Bill?

There are hundreds of cases already reported where bills received by the patients contained wrong or irrelevant charges, in which sometimes they had to pay an extra amount. The reason behind such errors is computerized documentation and lack of focus. Sometimes, hospital staff that creates a medical bill show an irresponsible approach, and most of the time they insert the wrong patient or service details in the bill. 

However if you want to avoid unowed charges, take time to read the bill and check the following things to make sure the accuracy of the bill:

Date and days: Re-check the actual dates on which you got the treatment. If you were hospitalized, then confirm the day on which you were hospitalized as well as the day on which you were discharged. If you were admitted at midnight, the date must be mentioned on that day. Whereas, if you are discharged from the hospital in the morning, you shouldn’t be charged for the rest of the day.

Numbers: Quickly filling out the form may alter actual numbers to fake ones. Check there shouldn’t any extra numbers especially zero in the charges.

Double charges: Carefully read each service and check you are not charged for a single service or supplies twice.

Medicine charges: Some patients bring the medicine with them at the time of treatment. If you did the same, check you shouldn’t be charged for that. Additionally, if a doctor prescribes you a generic medication, your bill shouldn’t contain charges for a branded medicine.

Routine supply charges: You shouldn’t also be charged for routine supplies like gloves, hospital dresses, or sheets. Generally, hospitals are responsible to bear these costs.

Canceled medicines: Many times a doctor or physician recommends you a medicine or treatment, but later on they cancel that. Double-check if that too is mentioned in the bill mistakenly.

Conclusion

Medical bills might be difficult to read, but with the help of our guide, you can now better understand your bill and charges. Verify the authenticity of the bill by making sure of the accurate expenses and save yourself from getting charged extra than you owe.