Most hospitals send a summary bill (for example pharmacy: $5,000) hoping you’ll panic and just pay it. These are usually full of errors or huge markups. Before you pay anything, call the billing department and ask for an itemized bill with CPT codes. This will not only force a human to review it, but it also gives you the ability to spot BS. I tried this last year and the bill dropped by about 30% literally just because I asked, so don’t let them rip you off.
Maybe this was true in 1967 when the typing pool and the accountants had to coordinate to whip up a bill by hand, but the number that the computer spits out is literally a spreadsheet sum of all the line items.
“Itemized bill with CPT” (if it’s a hospital bill they mostly use HCPCS with Rev codes anyway, so ask for “with procedure codes”) is exactly what they send in on insurance claims, so they already have it. It’s not any extra work, no one reviews it and compares it to medical records; it’s literally generated and pulled directly from the medical records.
Unless you are at a small rural hospital that still uses dot matrix printers with the ribbon paper, it’s highly unlikely this will change anything for you. It costs them the extra paper.
It’s still true in that the bill can go back and forth between the hospital and insurance and change.
I had a surgery about 5 years ago that started at about $45k, and every couple of days got the bill would change as things started getting picked up by insurance. Eventually it got down to just over $4k. I waited about a month and then still had to call insurance because my annual out of pocket was capped at $2k and they didn’t take that into account. Eventually it ended right around $1500.
This was all through the MyChart app, so it more it less does live updating after the initial bill is sent, opposed to a paper bill. Now I always wait about a month to pay any medical bills just to be sure, because if you over pay, you have to fight to get it back from insurance.
Yes a spreadsheet sum of potentially incorrect items, which the only way you’d know about is if you see the items, not the summary. Hence OPs post.
Not saying that it’s impossible… But, the way most of these codes are input is when a provider scans in a medication or procedure before they administer it.
Electronic medical records systems like Epic basically streamline physician notes with medical billing. It’s actually a lot easier nowadays to accidentally forget to input a billing code than it is to add extra billing information.
Tbh if you get a large and unexpected bill from the hospital, a more effective route is to ask if they have a hardship, charity care, or financial assistance program.
Hospitals, especially state funded ones like the one I practice at are so used to people not being able to pay their bills that we regularly have to write off a ton of medical care. They are usually more than happy to drastically discount care for people who are willing to pay for even part of their bill.