How to Dispute Medical Bill Errors
Updated: Sep 19, 2021
Scrutinizing a bill from your health care provider or insurer is probably one of the last things you want to do after getting out of the hospital, but it can pay off.
Medical bill errors should be corrected so that you don’t have to pay for a service you didn’t receive, for example, or for medication that was ordered for you but you didn’t use while in the hospital, among other potential errors.
Here are some ways to dispute medical bill errors so that your insurance company doesn’t overcharge you:
Get an itemized bill. Some medical providers may only send a “bottom line invoice” with a total amount due. Ask for an itemized bill that fully explains the charges. If you’re unsure what a charge is for, ask the provider.
Document and compare. You or a family member should document what medicines you received and when during your hospital stay. It will help you dispute any unnecessary charges.
Once you have an itemized bill, compare it to the explanation of benefits from your insurance company or your medical chart. The explanation of benefits is sent to you by your insurer, and hopefully you’ve kept it. It may charge for a chart, which should match the services listed on the bill.
Notify the biller, then others for help. Any errors you find should first be taken up with the healthcare provider’s billing department. It may audit the bill, asking you to provide evidence or documents to back your claim.
If it won’t correct the bill, ask your insurance company for help. You can also file a complaint with the state medical board or hire an attorney.
You can also hire a patient advocate who works on billing disputes. Such services include HealthCPA and Medical Bill & Claim Resolution. They can appeal erroneously denied charges and guide you through your insurance plan’s appeal process.
Companies such as Simplee offer free online services to gather your medical bills and insurance payments so its software can find if there are any mistakes.
Follow up. Lastly, when you appeal a bill or are told a problem is being fixed, follow up with a phone call or letter to ensure it has been resolved. Upon first contact, ask for an estimate of how long it will take to fix the issue, and contact them on that date.
If you don’t understand something, ask. It’s your right as a patient to be involved in your billing just as you’re involved in your medical care.
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