The first part of the problem was human error, the second problem is not. In fact you might argue it is intentionally a part of the billing system.
But even if the problem is mere coincidence it still gives me pause. All bedside care givers from nurses to techs to dietitians to lab personal all try to give quality care. But the focus seems to shift once the patient is discharged and the billing people are in the picture.
That is a pretty bold statement, but let me explain. I have auditing quite a few hospital and medical bills and frankly I am surprised at the blatant excesses.
As we explore bills in the coming weeks, I will show you how the bills are worded and set up. It is not with ease of understanding upper most.
Here is a quote that aired on the CBS News 60 Minutes program. It comes from Carmela Coyle of the American Hospital Association. “Actually, what hospitals charge for a service is the same for everybody, whether they have insurance or not. What’s confusing for everybody is that what a person ends up paying in this country can be very different.”
So to put it another way, a portable chest x-ray costs the same for everybody in the country. But we might pay different amounts?
This just one of the confusing parts of medical billing and reimbursement. And that is what I mean by being built into the system.
Here is how it works in a nutshell. A hospital has a “charge master” that is a giant list of prices for all services and supplies provided by the hospital. So when a patient is billed for a service the charge master is consulted. However, you as a patient may receive a discount on the full Charge Master price as listed.
But to make matters worse, hospitals keep this charge master secret. And as Gerard Anderson, a professor of public health at Johns Hopkins University notes, “That information isn’t available to you. In the hospital sector, you can’t do any comparative shopping. And because you can’t do comparative shopping, the hospital has no reason to control prices.” Thankfully that is beginning to change however.
Anderson knows about this, he helped write the Medicare rules that form the basis for what government and insurance companies pay hospitals. Asked why this can happen and Anderson replies; “It’s a long historical evolution, but essentially, they can get away with it.”
But the times they are a changing, because like taxes, everyone at some point in their life is going to get a hospital or medical bill. And in this case it happened to Richard Clarke. And because it did, he began the Patient Friendly Billing project.
In the next article Richard Clarke and Patient Friendly Billing will offer some hope for all of us.