How to Find Out if You’ve Been Overcharged On Your Medical Bill and What to Do Next

We want to take care of our health as much as possible, especially when there’s a pandemic around. Despite that, there are times when a trip to the hospital is unavoidable, not just because of the global virus. It may be due to a small accident, some arising health issue, or a simple checkup. However, you may be shocked to find at the end of your stay at the hospital that you seem to have been billed a little bit more and higher.

There may also be cases when you find that you’ve been accidentally billed for tests you didn’t take. If it isn’t that, you may somehow have found that you’ve been billed by your doctor four visits in a week when it should only have been one. A small shot or injection for some allergies may also reflect five digits on your bill. Even emergency room bills can have incorrect or excessive charges. During these unreasonable cases, you can dispute a medical bill that is either overcharged or billed mistakenly.

When these kinds of situations happen, you must take action as this could take a toll on your financial status, even when you have medical plans prepared.

Before you panic and worry too much about your bill, here are some things you can do to make sure whether you’re being overcharged or billed mistakenly:

1. Know Your Medical Record: In the emergency room, they can only charge you for treatment that you received in actual. However, there have been patients that have reported being billed for the treatment they didn’t even get. When this happens, it is crucial to find out what they have documented in your records by requesting a detailed and itemized bill that shows the breakdown and expense for each item.
2. Know About Out-of-Network Charges: It is necessary to be aware that unexpected costs can arise from treatment that has been rendered by out-of-network doctors and providers, even if the hospital you visited is covered under your insurance.
3. Carefully Look At Your Bill to Identify Mistakes: Some additional costs can be due to tests that were ordered by the hospital but then canceled. There may be times when the physicians also forget to take these out of your record, hence being included in the bill. Make sure to check your bill's details to know if there were any tests included in the list that never happened.
4. Compare Your EOBS and Medical Bill: Once you’ve reviewed your medical bill for any errors, compare it with your insurance company’s Explanation of Benefits or EOB. Check that these three correspond in both documents:

1. 1. What you were charged for
   2. The insurance company’s allowed amount
   3. What the insurance company paid for and didn’t

Should you then find that there are discrepancies, call the hospital or your insurance company to clarify. 

Once you have confirmed and found yourself needing to dispute medical bill that has errors or overcharging, here are the next steps you can take:

1. Know who you’re talking to – once you’ve contacted the hospital or the insurance company, take note of the name of the person you’re speaking to so they can be your reference when passing on details such as, ‘Person A told me to contact you,’ or ‘Person B explained that this would not be charged.’
2. Keep making calls – keep on making calls until you’ve got the right person to help you clarify your medical bill. You can even contact the doctor and ask them about the charge. Persistence and patience are very important aspects you should have during these cases.
3. Follow up – even after you’ve made calls, follow up the hospital or the insurance provider by mailing them a letter, sending an email, or faxing them. You can even do all three to get their attention.
4. Don’t be afraid to talk to your doctor – some end up not questioning their charges without getting proper treatment from the doctor or facility. However, most times, doctors are unaware of the cost of their services within facilities as they have billing agencies outside.
5. Get help from experts – there are groups and advocates who can help you out when everything feels overwhelming. Relax and know that there is a solution, and you can still find a way to lower your medical or emergency room bill.