Re: Medical Records & Hospital / Doctor Bills

July 12, 2003

Kaye,

You wrote, " I am laughing about the OCD! As a matter of fact I really get a

case of " OCD " when I read my own records because 90% of the time I found tons

of mistakes in them. "

I am just grateful that I can find humor in something. I think this is where

the saying, " laugh to keep from crying " started.

There are people who make their living finding errors in medical records,

from charging for small items like an IVAC on day too many to big ones, like

being charged for someone else's MRI, etc. What is amazing is that when there is

an item or procedure that doesn't have a code, it is the data input person

usually left to pick and choose another code that is " about " the same---same

what?

We may have done a thread about this already. But it is hard to audit your

bill when you have charges used in OB/GYN because they are about the same costs

as the one they need, but don't have a code for. The problem too is that the

insurance and Medicare won't pay, because it was an unnecessary test.

I don't know about the rest of you, but I can barely get a copy of my record,

much less audit it. And, yesterday, I sat down and tried to audit the status

of my medical bills, and had eye strain before I was half way through. Trying

to figure out if my bill is correct, then see if the insurance paid, then did

Medicare pay, what is the balance, have I paid. Gheesh. The hospital can spend

a year and a half working on reimbursement, then send you a letter stating

the balance is due in full. That happened yesterday. I couldn't put my hand on

the original bill and asked to have one sent to me, and she said, that's what

they all say. I was shocked at what came out of my mouth.

It is definitely a pertinent issue for a source of stress and an important

aspect of discharge planning and teaching, caregiver support, etc. Keeping track

of all this takes coordination and guidance. I have met many people who do

not know how to read their explanation of benefits, bills, insurance statements,

and such. And, that isn't anything to be ashamed of, it isn't an innate

skill. Maybe that would be a good Symposium topic?

Karyn E. , RN,

Exec. Director, PAI

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