A crisis of hospital bills - East Valley Tribune: Business

A crisis of hospital bills

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Posted: Sunday, April 23, 2006 6:37 am | Updated: 2:27 pm, Fri Oct 7, 2011.

Two years ago, Julia Zimmerman went to the emergency room at Banner Desert Medical Center because her blood pressure was out of control.

The Mesa resident ended up needing surgery and received a stent to open a blocked artery and improve blood flow to her heart.

“I went into the emergency room and into the hospital, and the next day they put the stent in and the next day I left,” Zimmerman said.

She thought her insurance would cover most of the cost, but that wasn’t the case.

“I owe the hospital, the heart doctor and the emergency room, and whoever these other doctors are, over $40,000,” she said. “The hospital bill alone is $35,000 for two and a half days. I had insurance, I thought, and they paid $500 for the total amount.”

Not only is Zimmerman drowning in medical debt, but also none of the bills include any explanation of the charges, Zimmerman said.

“There’s no explanation about why I’m getting this bill, who is it for or anything,” she said. “Half the time there’s not even a phone number. I have no idea where to go.”

Zimmerman is not alone in her frustration. Many Arizonans and Americans are facing financial hardships because of medical bills they’ve received without any detailed explanation of the charges, said Nora Johnson, an advocate trainer with Virginia-based Medical Billing Advocates of America. The organization helps individuals and companies with their medical bills and insurance claims.

“Go to any hospital Web site and look at the patient’s bill of rights, and the patient has the right to an explanation of any item on that bill that he or she doesn’t understand,” she said. “Any payer has the right to an explanation for any item that he or she is expected to pay for.”

Various health care providers, such as St. Joseph’s Hospital in Phoenix and Maricopa Integrated Health System, say they have implemented changes to make medical billing more consumer-friendly and already are receiving positive feedback from patients.

TIME FOR CHANGE

Phyllis Rowe, interim president of the Arizona Consumers Council, a consumer advocacy group, said most medical billing errors go undetected because consumers don’t question their bills and in many cases don’t know how to question their bills.

“Take the bill to the nurses or to someone in the hospital and say ‘What does this mean, what did you do?’ because sometimes they have put in things that the patient didn’t really receive,” she said. “Did they receive the oxygen? Did they receive the services that are mentioned in the bill? . . . People just sort of do the bottom line because they feel helpless. That’s unfortunate, because they really should be challenging things.”

Rowe said she has firsthand knowledge of what can go wrong in medical billing.

“I have a 105-year-old aunt who’s in a nursing home and this is the sixth year that she’s been there,” she said. “Every month I’ve had to look at that bill, and I’ve had to question something in the bill. I think they get away with things because people don’t look at them carefully. I’ve had other people who have patients in this nursing home ask me to look over their bills because they don’t understand them.”

Itemized bills may be lengthy and hard to understand, but it’s still worth it to request a copy, Johnson said.

“They’re usually anywhere from five pages to 30 pages or so on average,” she said. “I had one that was 257 pages.”

THE TRANSLATOR

For 35 years, LaVirdia McMurray was a medical transcriptionist. Her job was transcribing all patient information dictated by physicians. She is now using that experience as a medical billing advocate with Medical Billing Advocates & Consultants of the United States in Surprise.

“Many times, patients are being billed double,” she said. “In fact, I just got a bill back for myself and it was double-billed, and that is a very common problem.”

McMurray digs through her clients’ medical bills to make sure all of the charges are accurate. If she does recover any money, she receives 20 percent of what her client gets back.

“Many times a doctor may order medicine for you and actually you didn’t get it,” she said. “They changed their mind, and they continue billing you for something you didn’t get. They’ll bill you for, maybe $25 for a pair of latex gloves, and hey, that’s wrong. These are the kinds of errors that we try to address, the overcharges, the incorrect billings.”

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