Pat Palmer, a patient advocate and author of “The Medical Bill Survivor Guide,” estimates she finds an error on about nine out of every 10 hospital bills she examines and about seven of every 10 physician bills.
On top of that, an analysis of government data by the Kaiser Family Foundation in 2024 suggested that people in the United States owe at least $220 billion in medical debt.
That’s why I always recommend to my clients that they not pay a medical or hospital bill until they have received an itemized bill and carefully reviewed it. There are a lot of reasons for mistakes in medical billings. The most common on, according to a 2022 review, is duplicate billing.
Other common medical billing errors include:
- Incorrect diagnostic codes: This shouldn’t come as a surprise, as the fiscal 2025 diagnostic coding system (ICD-10-CM) has a total of 74,260 codes. And it’s a moving target, as codes are added and deleted each year.
- Typos: A typo can cause a single saline drip to be registered as many more.
- Incomplete or incorrect information: Information for a patient or provider might be entered incorrectly or incompletely.
- Upcoding: A sprained ankle seen in the ER could generate a bill for a higher level of care than was actually provided.
When you receive an unexpectedly large hospital bill, the first thing to do is take a deep breath, ask for an itemized bill (which you are legally entitled to), and review it for errors. If you think there are errors – or the bill is just too big for you to handle – the worst thing to do is to ignore it. Some hospital systems are quite aggressive when it comes to getting their money, using collection agencies and even liens and wage garnishments.
As a private patient advocate who has run interference between hospitals and patients for years, here are my recommendations.
Patients should always be respectful and polite and never use foul language or sound desperate. Just call and ask for the medical billing department and say you have some questions about your bill. Listen carefully, take notes, get the name of the person you spoke to, as well as the date. They will be recording the call; ask before you record anything.
After the bill is corrected, explain why paying it will be difficult and ask for options. Do not make an offer unless it seems reasonable to pay the balance with a credit card. Many health systems these days offer interest-free payment plans that allow you to pay the bill a little at a time with no penalty. They get their money, and you get a manageable monthly payment.
Cash is king, so if you do offer to pay now, they may give you a reduced rate just to resolve it. If the person on the phone does not make you a fair offer, hiring a patient advocate may save you thousands. I once made a $50,000 bill disappear when I pointed out that a medical error had occurred during the patient’s stay. Hospitals never want to get lawyers involved and will sometimes write off an entire hospital stay to avoid it.
Don’t agree to anything you are unsure of; simply say you need to discuss it with your spouse, children, financial advisor or whoever, and ask for their direct line so you can call them back. If you appear to be running into a brick wall, ask to speak with a supervisor. If all else fails, call the patient relations department and ask for their help or hire a private advocate.
A bit of planning might avoid surprise hospital bills. Review your health insurance policy to understand what is covered. If it’s a scheduled procedure, call ahead to the billing office to make sure it’s an in-network facility and get an estimate of your charges.
A final word of advice: Never, ever take a medical bill at face value.
ABOUT THE AUTHOR:
Teri Dreher Frykenberg is the founder of Nurse Advocate Entrepreneur.
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Tags: billing, doctors, Hospital, insurance, medical bills, medical costs
