Health Care

Hospital billing gripes

November 30, 2017
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Hospital bills can be very confusing. Clearly, some changes would help. Let me give a few examples of my gripes.

Recently I was at a restaurant where Local First was holding a celebration. Local First is dedicated to having local sources used. The event caused me to reflect.

It is interesting that I receive bills from Spectrum Health that come from Chicago and similarly demand that my payments be sent to Chicago. Not quite local. Makes one wonder if there are any local billing services that could do the job? In fact, the hospitals previously had internal staff handle billing, but now they want to outsource this important function. Can’t locals do the job? How about the banks that service the billing accounts? Where are they?

When the merger creating Spectrum Health was announced, the spokespeople said the merger would provide the opportunity for the local community to realize the efficiencies provided through local services. What’s changed since then? Billing out of Chicago? Health insurance marketing in southeast Michigan? What else?

There is the matter of the timing of bills, too. In November, I received a bill for services performed in February. I appreciate not having to pay for this period. However, shortly thereafter I got confused when I received a collections call from Spectrum Health only one week after receiving another bill — wondering where my payment is and threatening adverse action if I don’t pay up immediately. How about the practice of back-dating of bills — when the hospital’s billing service back dates the bill by at least three weeks and then giving a due date for payment of only one week? What about the practice of sitting on payment refunds for months? Perhaps I should talk to the people in Chicago about these things, but then they are the contracted agents of local folks. Perhaps the hospital boards should look into this and maybe go with Local First options? Come to think of it, what do the hospital boards do? Are they in charge? Do they like seeing local dollars going elsewhere?

It is my experience that hospitals can and do get things wrong. The American Hospital Association previously said that most hospital bills are in error. The Meijer Corporation even instituted a successful FBI program — Find Billing Inaccuracies — with employees sharing in any cost savings when errors were reported. We might be able to address errors if we could speak to local folks about them, but don’t ask me to go through some impersonal billing service elsewhere. They only go with what they’re given.

Hospital bills are very confusing to individuals. But payors also get confusing bills. Think of the reaction of the Medicare program when it received 217 claims between 2010 and 2011 for patients diagnosed with kwashiorkor in the U.S. For the uninitiated, kwashiorkor is a condition of extreme malnutrition, usually found in children in very poor countries. This is one of the diseases medical geographers study — usually associated with sub-Saharan Africa, not the United States. Medicare looked into the kwashiorkor claims and found that not a single one of the claims was legitimate. Yet the hospitals involved were paid more than $700 million for the 217 claims. After audits of the claims, the hospitals blamed “computer errors” for their inaccurate bills. Undoubtedly the involved patients probably needed care, but kwashiorkor?

Hopefully the faulty computers were put out to pasture. Perhaps a few others should be, too.

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