Medical Billing Errors Are Seriously Hurting Baby Boomers

Health care is a multi-trillion-dollar industry in the United States. Last year alone, American spent about $3.65 trillion on health care expenditures. That is $3,650,000,000,000. Even more staggering is the number of medical billing errors that occur each year in the United States. Experts say that between 30% and 80% of medical bills contain errors and an audit by Equifax found that there was an average error of $1,300 for hospital bills totaling $10,000 or more!

While doctors in the U.S. leave billions of dollars on the table each year due to poor billing practices, it’s the patients who are suffering the most. A study by NerdWallet found that medical debt is the single largest category of consumer debt in our country. In fact, one in six Americans will have a medical bill turned over to a debt collection agency. Americans can barely afford their health care as it is. They definitely can’t afford to overpay due to errors.

Medical Billing Errors are Costing Baby Boomers the Most

As you might imagine, a disproportionate percentage of these errors are costing baby boomers, those born between 1946 and 1964. People aged over 65 years currently make up just 13% of the U.S. population, yet this demographic currently comprises:

  • 35% of all hospital stays
  • 38% of emergency medical responses
  • 90% of nursing home care
  • 26% of visits to doctors
  • 34% of all prescription usage

Elderly people are the biggest consumers of healthcare resources by far and as a result, are more likely to be impacted by billing errors. Just a few months ago in September of 2019, 411,000 seniors who have their Medicare Part B premiums automatically deducted from their bank accounts were double billed for the month of September because of a “process error.”

Why are there so many medical billing errors?

The answer is actually quite simple. Insurers just don’t care. They negotiate a lower rate with medical providers, so the amount of the bill and whether it contains overcharges doesn’t really matter to them. At the end of the day, nobody is looking out for you, the patient. Although advancements in medical billing software and economical medical billing software prices are helping, healthcare is constantly changing, so challenges persist. For example, practices continuously need to train their staff about coding and billing updates. In short, medical billing errors aren’t going away any time soon. If you haven’t already, you likely will get overcharged on a medical bill. With upwards of eight out of ten medical bills containing errors, the odds are certainly stacked against you. Here are five great tips to help you understand medical bills and avoid overpaying for medical services.

  1. Understand your medical bills: The key difference between an Explanation of Benefits (EOB) and a medical bill is that an EOB comes from your insurance company stating the retail rate of your services, the contracted rate the provider has agreed to accept, how much the insurance company will pay and how much you will pay. Meanwhile, a medical bill comes from your medical provider and tells you how much you should pay.
  2. Don’t pay immediately: In general, people are eager to get their bills paid, but given the aforementioned statistics about billing errors, it’s best to wait until you’ve verified that the amount billed is actually owed.
  3. Verify all charges: As you’ve learned, there is a good chance that your medical bill is confusing and has at least one mistake on it. Request an itemized bill from your provider every single time and check each line item before you pay.
  4. Look for bill adjustment red flags: There should be line items on your bill showing an insurance payment and/or an insurance discount. If you don’t see this, it’s a red flag that your insurance was not applied to the bill.
  5. Make sure the EOB matches the bill: You should receive an EOB at about the same time as the medical bill. If you haven’t received your EOB, this means your insurance company hasn’t yet processed the claim to determine what portion of the bill you owe.

More great resources offering free expert help with medical claims:

Patient Advocate Foundation


Be the first to commment on this article.

Post a Comment