Slashdot Mirror
The Medical Bill Mystery
HughPickens.com writes: Elisabeth Rosenthal writes in the NY Times that she has spent the past six months trying to figure out a medical bill for $225 that includes "Test codes: 105, 127, 164, to name a few. CPT codes: 87481, 87491, 87798 and others" and she really doesn't want to pay it until she understands what it's for. "At first, I left messages on the lab's billing office voice mail asking for an explanation. A few months ago, when someone finally called back, she said she could not tell me what the codes were for because that would violate patient privacy. After I pointed out that I was the patient in question, she said, politely: 'I'm sorry, this is what I'm told, and I don't want to lose my job.'" Bills variously use CPT, HCPCS or ICD-9 codes. Some have abbreviations and scientific terms that you need a medical dictionary or a graduate degree to comprehend. Some have no information at all. A Seattle resident received a $45,000 hospital bill with the explanation "miscellaneous."
So what's the problem? "Medical bills and explanation of benefits are undecipherable and incomprehensible even for experts to understand, and the law is very forgiving about that," says Mark Hall. "We've not seen a lot of pressure to standardize medical billing, but there's certainly a need." Hospitals and medical clinics say that detailed bills are simply too complicated for patients and that they provide the information required by insurers. But with rising copays and deductibles, patients are shouldering an increasing burden. One recent study found that up to 90 percent of hospital bills contain errors. An audit by Equifax found that hospital bills totaling more than $10,000 contained an average error of $1,300. "There are no industry standards with regards to what information a patient should receive regarding their bill," says Cyndee Weston, executive director of the American Medical Billing Association. "The software industry has pretty much decided what information patients should receive, and to my knowledge, they have not had any stakeholder input. That would certainly be a worthwhile project for our industry."
So what's the problem? "Medical bills and explanation of benefits are undecipherable and incomprehensible even for experts to understand, and the law is very forgiving about that," says Mark Hall. "We've not seen a lot of pressure to standardize medical billing, but there's certainly a need." Hospitals and medical clinics say that detailed bills are simply too complicated for patients and that they provide the information required by insurers. But with rising copays and deductibles, patients are shouldering an increasing burden. One recent study found that up to 90 percent of hospital bills contain errors. An audit by Equifax found that hospital bills totaling more than $10,000 contained an average error of $1,300. "There are no industry standards with regards to what information a patient should receive regarding their bill," says Cyndee Weston, executive director of the American Medical Billing Association. "The software industry has pretty much decided what information patients should receive, and to my knowledge, they have not had any stakeholder input. That would certainly be a worthwhile project for our industry."
Welcome to the Panopticon. Used to be a prison, now it's your home.
as a senior administrative manager for a large health insurance company I see no reason why customers are boggled over these codes. Any schoolboy (provided your school wasn't free) could decypher this kind of billing. Anyhow, to clarify:
Code 105: we've run out of those little salmon things on the yacht in the hamptons. naturally we would call upon customers for this expense.
Code 127: truffle spread in the lounging room of the manor has expired. normally we do not assess this fee, however since we've gone to the trouble to obviously dispatch a manservant for fresh baguettes, this must be accounted for.
Code 164: The good luck brandy in the maybach has been found to clash with the petit fours and as such we will need to purchase a reisling instead. Part of this fee goes to jet fuel for the arduous trip to germany.
CPT codes: 87481, 87491, 87798: These are the inventory numbers for the delightful new mercedes we intend to purchase after returning from germany. The autobahn really is delightful you know.
Good people go to bed earlier.
105: Is the patient alive?
127: Does the patient have insurance?
164: Do we accept their insurance?
"National Security is the chief cause of national insecurity." - Celine's First Law
105: Destination charge
127: Additional dealer mark up
164: Dealer regional promotional advertisement fee
sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
A dose of socialism is just the bitter pill that might finally convince .....
Bitter pill ,,, that will by $275 please
Hell of it was I'd just switched jobs and didn't have a new insurance card yet, but was actually insured. Over the course of my career, I've probably paid $20,000 or so worth of medical insurance and I've had the insurance companies weasel out of paying anything every single time I've had to have a medical procedure. And the total cost of those procedures so far has been significantly less than $20,000. I've had three trips to the ER or urgent care over 25 years, totaling about $3000 worth of care. $1000 of which was for a moth raping my ear.
So fuck the medical system and fuck the insurance providers. Over the past three decades, I'd have been better of with a jar of leeches. At least those are honest about sucking your blood.
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
A young doctor and an old doctor chat over the water cooler.
Asks the old doctor: "So, what did you treat mrs. Smith for?"
Young doctor: "$17 000."
ODr: "No.... I mean: what did she have?"
YDr: "$17 000!"
Free, as in your money being freed from the confines of your account.