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What to Do If You Suspect Medical Overcharging

Patients have rights to healthcare they can afford. If you were involved in an accident that left you disabled or have undergone a serious medical condition, the cost of shouldering your medical expenses shouldn’t exceed fair market prices. When that happens, you may have been overcharged by the institution that catered to your needs.

Medical overcharging often happens for specific reasons. It could be the result of billing miscalculations and at times, the extra charges were added deliberately by the management. Whatever the case may be, you are well within your right to question unnecessary charges and pay a fair price for the services you receive. Here’s what you should do if you think you’re spending too much on certain medical expenses:

  1. Go over the receipt and ask questions

Before paying the cost out of your pocket, you will need to look at the bill carefully and make sure you understand each component. If possible, request an itemized bill from the medical provider and look for duplications and inaccurate charges. The institution may give you the right to dispute these discrepancies and issue a corrected bill. Chances are, they could review the charges, confirm the errors, and provide a more accurate amount, so always take hospital bills with a grain of salt.

  1. Compare prices with the services of other providers

Often, the high cost of medical services is justified by the level of quality offered. Even so, you will need to check if the cost coincides with fair market prices at the same quality level. For instance, you may be paying more for a CT scan of your chest when the bill exceeds $5,000 which is roughly the most you can pay for this service (the least being around $250). If the provider insists on such an amount, ask for local prices for the same service and see if there’s a big difference.

  1. Check with your insurance company

Not all medical services are covered by your current healthcare plan, so you should review your coverage and confirm which costs are included and which ones you will have to pay out of pocket. It’s also important to check if your carrier has processed your claims properly. Considering the amount of transactions it deals with each day, it’s not a surprise that your insurance provider made mistakes on their end. Give them a call and check if they properly looked over all of your expenses.

  1. Consult with a medical billing advocate

In case the institution insists on these charges and your insurance provider refuses to shoulder the cost, you might want to get a lawyer with thorough experience in handling medical billing issues. With their expertise, they will be able to detect discrepancies in your bill and assert your rights as a patient.

More importantly, they can also dig deeper and expose a case of healthcare fraud that may have affected current and past patients. With your medical billing lawyer, you will be able to avoid going bankrupt as a result of excessive charges and, more importantly, put a stop to a systemic cycle of unfair medical coding and billing practices.

Endnote

Medical overcharging goes against the rights of patients, especially those with serious conditions such as cancer. Asserting your right to challenge an excessively costly bill ensures your financial stability and encourages others to be more vigilant before paying.