Let’s say you took your car in for a service, and that the mechanic told you not to worry – he would get it all working again good as new. You trusted him, and he seemed to do as he promised. But when you get a bill for $2,350, you suddenly have a lot of questions. What’s this $58 charge without a description? Why was that $300 line item needed? What about the labor rate? Is it competitive? Would a cheaper oil work have worked just as well?
Medical facilities are a lot like auto service shops. If you want to save money, you need to know how to read your medical bill, and be willing to ask questions. Where to start? The best place is the line items on your bill.
You probably hate the thought of analyzing line item data as much as I do. But we do it if we can save enough to make it worth our time. Truthfully, there are very few of us who get worked up about questionable items costing a few cents, or even a few dollars (like say on your phone bill). We might even ignore charges of $5-$10, but at $20-$30 many on an average budget start to get interested. And we’re definitely interested at $50 to $100. So for medical items that can be $200 or $500 or in the thousands, we should be poring over our bills with the greatest scrutiny.
So let's cut to the chase. If you decide you’re going to bite the bullet and dig in, you'll notice that each line item typically has a procedure code, which is most likely labeled CPT (Common Procedure Terminology). Trisha Torrey does a good job of explaining what CPT codes are, so I won't do that here. For our purposes, what you need to know is that every hospital and medical office uses the same set of codes, so when you learn them, you can understand a medical bill coming from any hospital or medical office in the country.
The prices we are charged all depend on these codes. They are the key to your bill. By looking at codes, you can catch services you are mistakenly charged for twice, and if you have a good tool to help you, determine whether the wrong code was used (or the wrong price for the right code). A really good tool will even tell you different, cheaper codes that could have been used to describe the same procedure. The tool of all tools of course would tell you the cheapest reputable place to have this type of work done, showing you code by code comparisons for your entire bill.
If you think someone should be developing these types of tools – we do too. Join the Healthcare Pricing revolution at PricingHealthcare.com!