Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, November 16, 1994 TAG: 9411160114
SECTION: BUSINESS PAGE: B-8 EDITION: METRO
SOURCE:
DATELINE: LENGTH: Medium
But, just like a credit card bill or checking account statement, it should be reviewed for errors. That's what Pat Palmer does for a living. The Salem resident is a "ghostbuster" for medical bills.
Since she began Medical Recovery Service in January, she has helped 22 people and found discrepancies in the bills sent to 20 of them.
Those customers saved a total of $11,103, with another $3,000 in refunds pending.
Here are some of the things she encountered, not all of which produced savings. Some are just curiosities:
Costs for an EKG given prior to surgery were denied by an insurance company because the charge was incorrectly coded. Once the company knew it was related to surgery, it paid.
A man who got only an X-ray had a surgery charge on his bill. It belonged to another patient.
Duplicate $19 charges for radiology were posted on the same bill.
A separate charge for a surgical tray also was included in the bill for the surgery.
Charges were made for services dated as having been provided two days after the patient's death.
Each time a man went to his doctor for required monthly blood tests, he was charged $14 to have his blood drawn and taken down the hall to a laboratory, which then charged a lab fee. The man asked if he could carry his own blood to the lab and save money.
A woman receiving psychiatric care was charged $7 three times a day for a pill, although the dosage she was given was a half pill. When the facility was asked why she wasn't charged for 11/2 pills instead of three, Palmer was told that the other halves were "thrown away, and that's the way it's done."
Palmer advises consumers to know which benefits their health insurance provides and what it requires from the policyholder; ask what an unfamiliar term on a bill means; scrutinize charges for duplication; if a claim is rejected, ask if it was properly coded; and, lastly, do a little haggling, especially if you have no insurance coverage.
By asking for the discount that would be given an insurance company, Palmer won a $4,500 discount for an uninsured woman facing a $20,000 bill for a hip replacement.
Palmer charges a percentage of what she collects as her fee to a first-time customer. For that, she reviews two years of medical bills. If she doesn't collect anything for the customer, there is no fee. If someone wants her to continue a regular monthly review of bills, her fee is $20 a month.
As credentials, she offers what she learned from overseeing her parents' bills for several years. She also worked for five years a decade ago for Blue Cross-Blue Shield of Southwestern Virginia, now part of Trigon Blue Cross Blue Shield.
She saved her parents about $400 the first time she sat down with their bills, she said.
She then began helping her parents' friends for free.
She got a business license in January and started Medical Recovery part time; by early August, she was so busy and staying up until 3 a.m. so many nights that she quit her other job.
One of the absolutes she has discovered is that following up on medical bills can take a lot of time. Palmer routinely makes as many as 15 calls before she gets an answer.
A lot of charges go unchallenged because people don't have the time to pursue the answers, she said.
TIPS FOR HANDLING MEDICAL BILLS
Know what your health care policy does and doesn't cover. Read it thoroughly; study it
Always request an itemized bill
Study the itemized bill, looking for duplicate charges or unclear charges
Call the hospital, clinic or health-care provider and ask someone to explain any unclear charge
Ask for a discount, especially if your procedure is costly and you have no insurance
Source: Medical Recovery
by CNB