Medical bill errors: Consumer groups say it happens more than you think

NATIONAL — Getting a surprise medical bill can hurt just as much as whatever you went to the doctor for.

But some consumer groups said there are many mistakes in medical bills.

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As reported on News Center 7 Daybreak, the medical bills include mistakes from doctors, hospitals, and pharmacies.

Consumer groups say it’s important to know what to look for.

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It started as a cancer scare for Scott Sinagra.

“It jumped to the point where it’s like it’s a concern,” he told our sister station, WSOC TV, in Charlotte.

Sinagra said his doctor ordered an MRI. He states the officer promised to run it by insurance ahead of time to make sure it was covered.

He told WSOC that the doctor’s office told him it was covered.

“About two months later, I get a bill, and I’m going, ‘OK, well, where did this come from?’” he said.

Sinagra stated that he was under the impression he should not have owed anything, or very little. Instead, his bill came to about $5,200.

“Me, as the patient was, hey, I’m just doing what I’m supposed to do. I’m just being there to try to get healthy again and identify what the heck is going wrong,” he said.

He told WSOC that he asked his insurance what happened.

“They didn’t have any record that my doctor’s office actually reached out to them,” Sinagra said.

So, he says the insurer would not pay the claim.

“I think it happens more often than most people think,” said Craig Rae. He owns a medical equipment store with Frank Trammell.

Both constantly interact with patients and say that when providers make billing mistakes, they hear about it.

“We see it every day, and there’s a lot of anxiety and there’s a frustration from our patients,” said Rae.

Kevin Brasler agrees with that. He is with the nonprofit consumer advocacy group Consumers’ Checkbook.

“It’s a constant problem. It happens a lot,” he said. “The physician or the hospital didn’t bill their insurance plan, or didn’t bill it properly, or there was a mix-up with their insurance plan.”

So, what can you do about these medical billing errors?

Anytime you get pre-authorization for a medical procedure, try to get it in writing.
When your Explanation of Benefits (EOB) comes, read it. Remember: it is not junk mail. It might be the key to catching a mistake early.
If anything on the bill makes you nervous, call your insurance. Don’t wait.
If the claim involves medicine, not a procedure, and you can’t afford it: ask the drug company if it offers payment assistance or a discount. Many give coupons.
Be persistent

Sinagra went back and forth for months between his doctor’s office, the MRI provider, and insurance.

He said that the MRI provider finally cut his bill in half. But he really feels the doctor’s office is the one that should have made things right.

Either way, he says that he means he still owes about $2,500. That is thousands more than he said he should have.

“I just want somebody to take responsibility for their actions,” said Sinagra. “Me, as the patient and customer, just going, ‘Well, how am I stuck here holding the bag when I’m relying on the people to care for what I am going through to know that they’re supposed to do?’... So, we don’t get stuck.”

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