|Home | Protecting Consumers | Safeguarding Children | Seniors | Law Enforcement | Site Map | Search|
Sorting Out Medical Bills After a Trip to the Hospital
As much as we try to avoid them, illnesses and accidents do occur. Being sick is a difficult and stressful enough experience without having to worry about the inevitable bills you'll receive later. Hopefully, the information below will help with any medical bill confusion.
Following hospitalization, it is not uncommon to receive several bills that appear to be the same. It is easy to assume you are being billed twice for the same service when you receive two bills for a single service performed in the hospital, such as an X-ray. However, frequently what appear to be duplicate bills are actually bills for different services related to the procedure. Doctors who provide specialized services in a hospital generally bill for their services independently of the bill for the hospital's services using an arrangement known as separate billing.
What Is Separate Billing?
If your bills seem confusing at first, compare them with the different doctors who treated you and services you received during your stay at the hospital. Don't forget to include services provided by specialists during a non-emergency hospital visit, or during an outpatient visit, in your comparison.
When you come home, you probably would expect to receive a statement from the hospital. This statement lists charges for the use of the emergency room, drugs, and supplies. Nurses and technicians are included in the room and board rate.
However, the charges for the attending specialty doctors who treated you may not be included in the daily room rate. Many doctors contract with the hospital to serve patients and to staff the hospital's various departments. These doctors are not hospital employees and may bill patients separately for their services. Therefore, you may receive separate bills from each doctor who treated you, as well as a bill from the hospital itself.
Billing Language Varies
Every medical procedure is assigned a number known as a CPT (Current Procedural Terminology). The CPT number identifying the procedure may appear on the bill your doctor sends you. The bill may also briefly describe the services provided, or itemize every procedure separately. There is no standard language all doctors are required to use on the bills they send. Therefore, two different doctors specializing in the same area could send bills that look different.
Hospitals do not have standard billing language either. However, Maryland
hospitals must send an itemized bill that briefly and clearly describes
each item and the amount charged. Maryland hospitals must also provide
you with a summary statement of your account within 30 days after you
are discharged. You may request an itemized statement of your account
up to one year after discharge, and the hospital is required to provide
it to you within 30 days. Having an itemized hospital bill should make
it easier to understand the related bills you receive from specialists.
If you are a member of an HMO, keep in mind that the law may protect you from being billed beyond your applicable co-payments or deductible, a practice called balance billing. Medicare providers who accept assignment are also prohibited from balance billing.
Identifying and Solving Billing Problems
Here are some steps you can take to better understand your bills and to solve a billing problem:
For more information
regarding medical billing, please contact the Consumer Protection Division's
Health Education and Advocacy Unit at 410-528-1840 or toll-free at
Attorney General of Maryland 1 (888) 743-0023 toll-free / TDD: (410) 576-6372