Monday, October 11, 2004

Bloody Scary...

I'm helping a relative deal with some recent medical bills, trying to reconcile the hospital statements with the explanations of benefits from the insurance company.

It is not a pretty sight.

For instance... the "prior charges" dated 7-15-04? They tell me it was for an emergency room visit. But the ER visit was only $182.40, not the $312.40 on the statement. And their computer cannot tell me where the other $130.00 came from.

Same with a "pharmacy" bill for 8-31-04, for $2422.55. You cannot tell me that a patient used up $2422.55 worth of pills in a 5-day hospital inpatient stay. That would be an average of $484.51 worth of pills per day. Even at an outrageous, say, 3 bucks a pill, that would be over 160 pills a day! I know for a fact the patient was not swallowing THAT many pills!

The account person at the hospital needs to consult somebody else and find out what that $2422.55 is for, because they're "working on" getting the computer system to spit out an itemization.

Now this is downright scary. I am a medical biller by trade, with nearly 30 years of experience. And I cannot figure out these bills. I can only imagine how hard it is for patients who do NOT do this for a living!

Remember, we're professionals. Don't try this at home!


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