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Be on the Lookout for Medical Billing Errors

Written by Nickel - 2 Comments

About two weeks ago we received a medical bill from a local hospital for some lab work for my son. When I opened the bill I was shocked to see that we owed a princely sum. I was under the impression that we’re on the hook for 10% on diagnostics with no deductible, yet the full amount of the tests ended up going to our deductible. When I called to inquire about this, I found out that the pediatrician’s office had sent his blood to the wrong lab…

They first tried to argue that it was our fault, that we should have known that a lab test sent to this hospital wouldn’t be covered. I argued that we had no idea that they’d be sending it out for processing, much less where they’d be sending it — since they’re ‘in network’ how could we have anticipated that they’d send it ‘out of network’ for processing? When pressed, the office manager admitted today that the lab tech had sent it to the wrong lab. When I inquired about what would happen with the bill, she replied that she needs to call the hopsital that they sent it to and see if they can work it out. I can’t imagine that the hospital will budge, as they didn’t do anything wrong. My view is that the doctor’s office should be the one to eat the cost (down to the 10% of allowable charges that we would have otherwise paid), as they’re the ones that screwed up. Regardless of how this plays out, the lesson here is that you need to cast a critical eye at your medical bills, as no one else is looking out for your interests.

Funny side note: My son, who is five, was convinced that the pediatrician had to draw blood because he had too much of it. He was further convinced that he might need to go back in, as he didn’t think they hadn’t taken enough.

P.S. Sorry for any RSS weirdness over the past day or two. My redirect to FeedBurner somehow got screwed up. It should be fixed now.

Published on June 6th, 2005
Modified on August 9th, 2005 - 2 Comments
Filed under: Insurance

About the author: is the founder and editor-in-chief of this site. He's a thirty-something family man who has been writing about personal finance since 2005, and guess what? He's on Twitter!

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2 Responses to “Be on the Lookout for Medical Billing Errors”

  1. 1
    Caitlin Says:

    Good advice…LaLa just went in for routine blood work and somehow the claim came back denied because she didn’t show up as being covered at the time. It boggles the mind.

    This is just a hint of the errors that are being made on the claims side of things at our insurer that we are currently trying to rectify. If only they let us put in our own claims online…many typos and errors would be avoided IMO.

    Guess this is a current sore spot for me…

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