5 Tips For Finding Medical Bill Errors

Stethoscope and laptop on white desk in doctors office
StethoscopeDan Dalton / Getty Images

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By Ben Popken

After you recover from the pain of medical procedures, sometimes there's the additional ouch of the hit to your wallet. But sometimes, that sting doesn't have to be quite so severe. By one estimate, over $68 billion of health-care spending is erroneously charged.

To prevent and treat the post-hospital illness of overbillingitis, take these five tips and call your doctor in the morning.

1. Price check before your procedure

Before you even go in for a test or surgery, call up and ask what billing codes your providers will be submitting. Then, call your insurance provider and find out how much they'll be covering. That should give you a head start on seeing whether the charges afterward make sense.

2. Get a receipt

Ask your provider for a detailed, itemized statement. Review it line by line and make sure everything adds up. Look for errors in things like your name or the insurance group's number, as well as duplicate orders and upcoding, which is when your procedure as coded as something more serious (and more expensive) than it really is. If you were billed for a medication, make sure you actually got it.

Read More: Hefty Surprise Medical Bills Can Be a Burden for Families

3. Call your provider

Once you get your bill, if the numbers still don't add up, call your provider and ask them why they processed the claim the way they did. You might catch something amiss and be able to correct it. For instance, a surprise high bill item might come from them rejecting a charge, which could simply be a coding error. Find out, and then ask your provider to resubmit any erroneous items.

4. Write a dispute letter

If you're still stuck in a billing tug of war, you may have to send in a dispute letter. The FTC offers a sample letter to use as a starting point.

5. Get help from a pro

Claims.org and NAHAC can help connect you with patient advocates who can decode your paperwork, look for errors and lobby on your behalf with insurance providers. You can also hire a medical bill advocate through billadvocates.com who will help you reduce your bill, either for an hourly fee of $50-$175 or on a commission basis.