Will your hospital bill you for its own mistake?
Filed under: Ripoffs and Scams, Health, Fraud
If you bring me your computer and ask me to put in a new DVD burner but somehow I remove your hard drive and leave a screwdriver inside your computer, how would you respond to me asking you to pay for the "service" rendered? Wow! You can stop with the profanity it was only a hypothetical question. Now imagine that You've come to the General Hospital in Ohio to get your right leg amputated and we accidentally remove your left leg, and then had the audacity to bill you for not only the correct amputation but also for the mistaken one! You may be as surprised as me to know that only 23 states have rules against charging a patient for certain mistakes!As I look at my state of residence there is nothing official to stop them from billing me for a medical error. Instead I am supposed to take comfort in the knowledge that they have adopted guidelines to deal with cases such as these. Unfortunately despite these wonderful guidelines the local hospital has in the recent past billed at least one individual for surgery on both of her knees, after initially operating on the wrong one. If nothing else, I can be assured that my insurance company will fight these charges with the same tenacity they fight legitimate ones. That's kind of comforting. . . not!
Mistakes of this kind are referred to by hospitals as "never events", a slightly ironic term since they seem to be happening rather often nowadays. Maybe we can lobby for better legislation and a name change to classify these occurrences as "never say never events". Before you initial your limb for surgery next time be sure to find out what mistakes, if any your state provides protection from.
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Reader Comments (Page 1 of 2)
8-13-2008 @ 1:40PM
Shasiti said...
I work in the Health Care Industry and have caught hospitals, Drs. offices, Urgent Care Centers, labs, and the list goes on to ANYONE that provides a medical service to us. They charge for their mistakes and for services the patient has never even recived!! Problem is they charge the insurance company, then the state agencies such as Medicaid and the patient. I have caught them triple billing and being paid!! They will not acknowledge that this happens until they get caught, and then of course it is always a mistake and good luck trying to get any of the money back!! These people need to lose their licenses and do jail time for these MISTAKES and ACCIDENTLY over billing. Elderly people are targeted the most as they are not sure what they owe but pay it anyway!!! AMERICA'S health care systems sucks and they are all Liars and Theives!!
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8-17-2008 @ 8:58AM
Lasza said...
I don't know what you do for the healthcare industry but I am a billing manager and it is my job to charge and review charges for hospital services. The truth is that mistakes exist everywhere and most times (90% of the time) these are not intentional. The hospitals are under staffed and there is a lack of experienced hospital workers. There are electronic systems which are set up to bill automatically but only a manual entry can remove and/or credit a charge if it is wrong. Believe it or not, the errors made in hospitals are similar to receiving a wrong order in the drive thru. Poor training and/or experience. People who work in hospitals don't intentionally set out to cause anyone harm or make their lives miserable. You can't possibly work in a role of importance or else you would know this. Are you an EVS worker?
8-17-2008 @ 10:28AM
Bill Morris said...
Thank you! Your observation is correct, we live in an era where there is a loss of accountability, when mistakes happen no one accepts responsibility, the billing offices of the hospital are protected from recourse or a face to face meeting with their victim is unheard of. Corperations out source customer relations, your compliants are directed to an innocent ocean's away, the culprit remains in the shadows unaccessable, no contact with the result of their carelessness or unconcerned lack of manners. I believe it is a monkey see monkey do learned trait from our government agencies.
8-13-2008 @ 1:40PM
Sally said...
It will if it's Inova Mount Vernon in Virginia.
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8-17-2008 @ 6:47AM
Mike Cannone said...
I have a procedure at least once a month and the hospital sends me a bill after they have accepted the insurance. I know this is illegal and every month I have to correct the hospital and go back and forth between the hospital and insurance co. I told them both next time I am not doing anything to correct this. If you dont know your job then its not my fault. When they place a lein against me I will sue the hospital. Why are they paying these people to do their job when I actually have to tell them every month what their job is? I can not believe these people are that dumb.
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8-17-2008 @ 6:58AM
Marilyn said...
If an attorney represents you, but is under the influence of drugs and you are unaware, you should get triple the money back you paid him for services and he/she ought to get an automatic 5 year suspension from practicing law.
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8-17-2008 @ 7:47AM
XCALIBER75 said...
I too work in the health care industry. More specifically in the billing area for over 10 years. I can tell you that I go to extraordinary lengths to make sure the billing is correct. Billing insurance companies, Medicare and Medicaid is an extremely complex process. Yes, we make mistakes, but I can honestly say that I take pride in sending out correct claims. But I also know that there are a lot of others out there that do not operate under a code of ethics and professionalism. I just wanted you to know that some of us really do care.
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8-17-2008 @ 9:09AM
Bill said...
Ive been in the medicial field for over 20 years and have seen it all. One of the problems is not only the billing and most often poor care given that sets it up for these mistakes. The main reason for this is that most hospitals dont want to pay there employees. So they get what they pay for when it comes to help. Its truely sad that people who work at McDonalds get almost as much per hour as someone who cares for your daily needs while being sick and in the hospital.
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8-17-2008 @ 9:10AM
Joy said...
When I returned to college a few years back, I wasn't able to afford med insurance, so I had to pay out of pocket for all my yearly visits (pap smears, etc.). I had moved, so I had to find a new doctor, who had a habit of making me wait 4-6 hours after my original appt. time to finally have my 10 minute exam. After the fourth time of making me wait that long, when I got to the payment desk, I asked for a piece of paper. I wrote an invoice for the time I had to wait, handed it to the woman, then told her I'd consider their account paid in full, if they would excuse my bill. I then walked out and found another doctor.
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8-17-2008 @ 10:29AM
NANCY said...
IT'S NOT ONLY DOCTORS THAT MAKE YOU WAIT. REPAIRMAN DO THE SAME. THEY SAY THEY'LL BE AT YOUR HOUSE BETWEEN 8 - 5. YOU MAY WAIT ALL DAY AND AFRAID TO LEAVE THE PHONE IN CASE THEY CALL. LIGHTNING STRUCK THE WIRELESS BROADBAND I HAVE. I WAS WITHOUT SERICE FOR ALMOST 2 WEEKS AND THEY WEREN'T GOING TO GIVE ME CREDIT BECAUSE IT WASN'T THEIR FAULT. THEY FINALLY GAVE ME $5 OFF MY BILL THAT MONTH. MOST OF THEIR EMPLOYEES ARE RELATIVES, YOUNG AND INEXPERIENCED. I GET TERRIBLE SERVICE. IT'S THE ONLY COMPANY THAT HAS SERVICE IN THIS RURAL AREA. A LITTLE RAIN AND MY BROADBAND AND CABLE TV GOES OFF. I CAN'T GET TV RECEPTION WITHOUT CABLE. LACK OF TRAINING AND LOW PAY IS THE RESULT OF LACK ADAISCIAL SERVICE. SOME JUST WANT TO DRAW A PAY CHECK BUT NOT DO THE WORK. MOST ARE UNDER PAID. THEY GET WHAT THEY PAY FOR AND WE THE CONSUMERS SUFFER FOR IT. MY BROADBAND WAS NOT WORKING PROPERLY AND I HAD AN APPOINTMENT FROM 8 - 5 FOR A REPAIRMAN. WHEN THEY HADN'T SHOWN UP BY 4:45 I CALLED AND WAS TOLD A CABLE HAD BEEN CUT AND ALL THE REPAIRMAN WERE BUSY. I SAT HERE ALL DAY WAITING. I SENT A BILL FOR $80 ALONG WITH THEIR BILL AND SAID MY TIME WAS WORTH SOMETHING. THEY THOUGHT IT WAS A JOKE. THEY SAID ALL I DID WAS COMPLAIN WHEN I CALLED CONSTANTLY ABOUT MY BROADBAND NOT WORKING. THE MANAGER HAS BEEN QUITE RUDE TO ME. THEY THINK THEY CAN BE RUDE AND PRETTY MUCH USELESS WHEN THEIR THE ONLY APPLE ON THE TREE.
8-17-2008 @ 9:34AM
jitterbugh said...
Lasza, surely you realize you can't speak for every hospital? How immature to assume the inital poster is an EVS worker just because she has witness bad charging practices. I'm an RN but most importantly I've also been a patient more than my share. I have had to fight with the hospital I work for over a bill for my son's ER visit even though he had double coverage. It took a year to get them to bill the insurance right and then they still sent me to collections even though they promised they wouldn't since it was their mistake. If they are doing that to employees what are they don't to people who don't know better? Also, it's not just the hospital fees, it's the surgeon's, the anesthesiologist's, the assistant surgeon, the ER, etc, every little bit ads up and if you multiply all of the extra bills that slip by that's a huge extra income for the corporations that own the hospital. So many people complain about not wanting to risk "socialized" medicine by having some type of govt regulated health care system, but they have no idea how much that would help to curb the eroneous charges that private citizens are having to pay. Patients pay for all the discounts the insurance companies get, by paying hiked up prices for services that we can't even shop around for and half the time receive poor quality care. I'm a good nurse, but the things I've witnessed as far as bad practices and over billing (yes, even billing for mistakes) would make anyone ill. The system is in bad need of an overhaul. I know too many people losing their homes over those hiked up medical costs, it's not right when the physicians and inurance corporations are just getting richer.
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8-17-2008 @ 9:49AM
Elwood said...
I'm sure a lot of mistakes are made within the health care system. I'm sure many mistakes are caused from a lack of experience by the people doing the mistakes. To address the hour rate of these people I don't believe that's the problem, I think it's a lack of good supervisors in the billing feild to make certain all the work is handeled properly, with any paper work .
As far as bad procedures , the liability should be with those involved no questions ask.
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8-17-2008 @ 10:01AM
JETCHARTER1 said...
Hospitals are infamous for mistakes and overcharging. If you're going to the hospital for anything, pay attention to the services they provide, the supplies they use for YOU, down to the last bandage! Keep a notebook and record everything. Ask questions as to what medications they're giving you BEFORE they give it! Ask to see your medical chart DAILY! They'll probably say you can't..(their policy), but it's YOUR RIGHT AND INSIST..IF THEY REFUSE, TELL THEM YOUR CALLING YOUR LAWYER! You'll see just how fast you'll be reading your records! If you're not in a physical condition to do this, you need somebody who is smart,and knows what's going on to watch you and the situation like a Hawk! It's your only way to protect yourself. If you go for surgery, before they give you ANY pre-op medications insist that the ENTIRE surgical team be present and ask them what type of surgery they're going to perform and where! Then when you're sure they have the right patient and procedure, let them proceed. IT'S YOUR RIGHT! You have the right to REFUSE any medications and treatment you don't want. If you're not sure, CALL YOUR DOCTOR IMMEDIATELY! If you're receiving poor care, don't complain to the nursing staff, CALL YOUR DOCTOR, you'd be surprised how fast the staff will shape up. As for the overcharges, you've got your list of what they've done and used. Compare it to the bill. You'll ALWAYS find charges for services and supplies not used. Notify the hospital by certified letter with the disputed items circled on a copy of your bill. INSIST they remove these items immediately! Refuse to pay their rediculous charges for supplies and medicines ($3.00 Bandages for $60.00..etc.), they're not charging your insurance company this amount, but it shows up as part of your 20%! FIGHT! FIGHT! FIGHT!...YOU'LL WIN!
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8-17-2008 @ 10:06AM
jitterbugh said...
I should have mentioned another point in my previous post...one of the biggest "secret" scams of them all: Non-profit hospitals--quite a big joke!!!
The hospital I work for is supposedly "not for profit" while their "business" runs a huge number of Catholic hospitals on the west coast region. They are raking in massive amounts of money at the expense of the average American who has no clue they are being ripped off every day. Just think, if you over charge a million people by 1 dollar that's a million dollars and I'm talking over charges or "mistakes" being billed by way more than a dollar. Someone at the top is getting over paid...and if you think those discounts the insurance companies are getting aren't an issue, think again. Those discounts happen at our expense by paying the hiked up eroneous charges that most average people can't even afford, especially the ones who don't even have insurance at all. The medical system is more out of control than our housing crisis in this country but no one can talk about it out in the open because everyone is afraid to tackle the big pockets of insurance companies and physicians (many of them own interest in the hospitals they work for). I became a nurse because I wanted to help people, but instead I've gotten a disgusting lesson....that hospitals are not there to help people, the higher-ups act like any other corporation,they are there to try to get their employees to cut overhead costs and bring in more funds. It's BUSINESS...just like any other. It's a huge, sad, disgusting mess of a system. Anyone who says otherwise hasn't witnessed the reality of the situation or has a very sheltered view.
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8-17-2008 @ 10:08AM
Katy said...
If the majority of you posting responses to this article are healthcare workers or invoved to any extent in the billing process I'm really not surprised at the "mistakes" that proliferate the profession.
Your grammar and misuse of punctuation at the elemantary level speak volumes!
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8-17-2008 @ 10:13AM
Sarah said...
My mother wasn't so lucky, the butcher that worked on her legs told her she would get used to limping around everywhere. She endured a massive infection in her leg and it had to be broken again and reset. The steel rod placed in it had snapped due to the infection and her leg was curving inward. No lawyer would take her case because she hadn't been able to afford a stupid shrink. My father wanted to kill that sob. Then to top that off, when I got injured some idiot doctor recommended that same butcher as someone who could "fix" my arm. I told her I'd rather cut it off myself than let Dr.Sharp touch it. When asked why I hated him I told her to ask him about the way he treated his poor patients. I never have or will trust the medical establishment in this country. They're a bunch of criminals who just want money.
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8-17-2008 @ 10:18AM
John said...
Wow, some people just don't get it. Den, hospitals don't GIVE discounts to insurance companies. Insurance companies have the power to say "We'll consider you as part of our network if you only charge x amount of money for a certain procedure. Otherwise, we won't give you access to these patients at all." And what can the hospitals do? They are pretty powerless against the insurance companies. I'm not sure how your theory of hospitals cutting major deals to insurance companies (representing most of their patients) fits into the ideas of capitalism, or good business for that matter. So, erm, I hope you were kidding.
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8-18-2008 @ 8:16AM
Doc said...
Well said. I can't believe some people actually believe that everyone that works in this industry is a criminal that just wants money.
So much for Doctors without Borders and all of the other charitable organizations that do a lot of good for people with little or no recognition or support.
The insurance companies control a lot of what is done in healthcare, from hospitalizations, to medications, to home health care (or lack of it). Reform is definitely needed.
8-17-2008 @ 10:26AM
Doc said...
Providing healthcare is a BUSINESS. Non-profit or for-profit, you have to make money in order to continue to function. How much money to make is another debate that I won't go into here, but here's another way to say it: If your hospital doesn't make money to sustain its operations and plan for the future (or the unexpected), it will cease to exist. If the hospital doesn't recruit and retain skilled and competent staff, it will become irrelevant.
Don't generalize and say that all health care related billing is fraudulent or in error - some of it is, of course, but it is not the majority. These are the cards we've been dealt, we just have to work better to improve what we have. Some reform is clearly needed, but don't trash what we have now because it is the only system we have!
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8-17-2008 @ 10:54AM
c said...
I took my son to the emergency room, sat there in the waiting room for almost 2 hours. The only thing they did was file paperwork, and have a nurse of some sort check my son's blood pressure, and take his temp. Then, they referred us to another emergency room in another hospital because they have a children's hospital and this one did not. So, I drove my son to that emergency room and got treatment.
A while later, I got the statement in the mail (it was a "you don't pay this, we're billing the insurance" type of statement). It was over $2,000 from the first hospital. For what? My son never even saw a doctor there! It doesn't take a genius to take a blood pressure or a temperature. He never even took up a bed.
So, I called my HMO and told them that I disputed the bill. I explained to them why I thought $2,000 was outrageous. My HMO told me that it was THEIR responsibility to pay the hospitals, and they weren't going to dispute the charges. I was basically told to "but out" of the process. And, to tell you the truth, my HMO is not very good. They deny proceedures and equipment we need. We have had to go to the insurance commissioner in my state who helped us get some denials overturned. So, I found it quite ironic that when my son actually needs care, they deny it, but they'll go ahead and pay a bill, telling me to stop disputing the charges, for care that my son never got.
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