Lower Medical Bills Blog
Free Tips and Guide to lower your Medical Bills

Whether you are seen in the Emergency Room or are admitted to the hospital, all items on your medical bill come from a doctor’s order. If you get an IV it is because the physician wrote the order, x-ray, labs, any medications, splints, crutches, dressings are all the same thing.

Of course in the real world things are much more complicated, but for now it is a good place to start. Later on I will give examples of what supplies Medicare will allow and what Medicare will not allow.

Back to the example, once a physician writes the order it is placed in the computer. If a lab test was ordered it will specify what kind of test and maybe even if the venipuncture is to be done by the phlebotomist or a nurse.

Likewise, if an x-ray was ordered it is entered into the computer. On the computer screen it will specify if it is to be a portable x-ray or not, and what body part is to be x-rayed.

From personal experience I can tell you that personnel from both radiology and lab will ask “is the order in the computer”? And rightly so, the radiology technician and all the lab personnel want to be paid. The order that was generated by the computer entry will be billed to the patient to pay for the service performed.

By the way, nursing services are included in the cost of the room or as part of the ED visit. Nursing services by and large are not billed separately. Nor can we take tips, although I have been offered one more than once.

Anyway, that pretty much describes billing for service, no matter if the service is a lab test, x-rays, dietary, respiratory treatments, physical therapy, or occupational therapy. Even consultations for another physician’s opinion, such as a surgeon or gastroenterologist are put into the computer.

But for supplies it is a different matter. I have seen supplies charged out using little stickers on the item that are placed onto “charge cards”. And I have seen a bar code reader that scans the item for the appropriate patient right in the supply room.

In that way the patient is billed for the item used. Also it gives the hospital some means of inventory control, how much of what item was used.

Now again this is simplistic and later on I will contradict myself when we discuss routine versus ancillary services. But for this most basic approach that is how the patient is billed.

It seems like a straight forward system. And it is, but as we continue our look at medical billing errors and overcharges you will see how this becomes incredibly complex.

During my career I have worked in a variety of settings.  All over the hospital, I have worked in pediatrics, the burn unit,  neuro, trauma, cardiac, surgical and medical intensive care units, as well as in the the emergency department. And mostly the patients were grateful for the care they received.

When they are lying in the hospital bed, costs and the bill aren’t upper most in their minds. In fact more often than not family members have told me to do everything you can for their loved one, not even considering the cost.

It is when they get home, weeks later, when they receive the bill that the surprise comes. And while most I am sure, feel they should pay a portion of the bill, some are completely flummoxed how a 3 day hospital stay can rack up tens of thousands of dollars.

No doubt you have heard stories about out of control costs and bills being sent to collections, they are easy to find online. And I can imagine the anxiety and sleepless nights some must feel, not being able to pay there debts.

So in keeping with the tradition of patient advocacy that nurses adhere to, this blog will examine some actual hospital and medical bills. Throughout the weeks ahead you will see how those bills may be overcharged or in error of 400% or more.

There are excellent resources on the internet including 10 Ways to Avoid Outrageous Hospital Overcharges. But I intend to provide more information and examples from the bills I have audited.

Follow along as hospital bills are examined, and in one case you can decide for yourself if the hospital billing and coding department was guilty of fraud.