Ask Christina: Am I Being Overcharged By My Hospital?

By NerdWallet Health health finance expert Christina LaMontagne.

Question:

I have medical bills from a recent emergency operation and want to confirm they are not overcharging me. This is important because I have a high deductible insurance policy. How can I check that I’m being charged correctly?

Answer:

You can start by researching the market price for the surgery that was performed. There are many resources for this: FAIR Health Consumer Cost Lookup and NerdWallet’s Best Hospitals Tool are two examples. These tools will tell you whether the charges are totally out of left field or within reason.

If your bill is wildly different from the going rate for your procedure, you should be meticulous about checking for errors. Either way, however, be sure to request an itemized bill from your provider, which will allow you to check each item you’re being billed for. Compare this to your Explanation of Benefits, or EOB, which will contain details including the amount your health care provider billed your insurance company, the total amount that was not covered and the total cost to you.

Here are a few of many common mistakes to keep an eye out for:

• Duplicate charges: Double check that you’re not being charged twice for a service or procedure you received only once. This may not be immediately obvious on your itemized bill, but check each line closely.
• Incorrect patient information: These common and small errors can lead to massive differences on your bill. If your subscriber ID is off, your policy could be mistaken for one with very different benefits and coverage.
• Operating room and anesthesia time: Because you underwent an operation, this is an important one to check. You might uncover an error that just doesn’t add up — for example, the time you spent in the operating room and under anesthesia shouldn’t be too different. These services are typically billed in 15-minute increments, so errors here can multiply.

If you identify errors on your bill, make sure to get them corrected before proceeding. Start by calling you insurance company, and then follow up with your provider’s billing office if necessary. If your bills are to complicated to navigate yourself or you’re getting the run around from your health insurance company, you might consider hiring a medical bill advocate, who can both find errors on your bills and get them lowered by contacting your insurance company and provider for you.

NerdWallet Health helps patients reduce their medical bills—get started at health.nerdwallet.com. Have a question for Christina? Submit it to AskChristina@nerdwallet.com.

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