Hospital Billing Problems Part I
Let’s do a quick review; most items that appear on your hospital bill first originate as a physician’s order. The computer stores the order and billing is carried out. For supplies the patient is charged by various methods including stickers transfered from the item used to the “charge card”.
It is no surprise in this day and age to read about hospital bills gone awry. Millions upon millions of dollars mistakenly included on a medical bill. That is what Part I will address, human error.
Mistakes happen, that is part of life. And sometimes when we try the hardest we make the most. The same applies to entering orders. A wrong test is ordered, or wrong date or not in proper time sequence. It could happen and it does happen.
I know I have been called by the lab and radiology and even dietary asking about an order in the computer. Just the other day I was called by lab and asked if I wanted the magnesium level drawn now even though one was done earlier in the morning. Since there was no order I said no.
Safety of the patient isn’t compromised purely waiting for an order. So the service is rendered first and then an order is put in, most times the department will remind you to do so. So a stat x-ray can be completed with the promise of an order later.
And when the situation has calmed is an order placed? Well certainly that is the goal to charge for services rendered, but in reality sometimes it is missed.
Other safe guards are in place also, for instance hospitals may require doctors to enter their own orders into the computer. This eliminates several steps and presumably would cut down errors. Nurses routinely do chart checks to make sure the orders are noted and correct.
And remember those stickers and supplies? I can give you a personal example, this happened a few nights ago. I had two sick patients and I was very busy running from room to room giving care. At the end of the shift I had sticker all over my uniform top from the supplies I had used.
When it was time to affix the stickers to the “charge cards” I had to remember which sticker and corresponding supply I used for which patient. I am sure I did just that, but with the acuity of patients nowadays and the hectic work load stickers can be misplaced.
Something simple intended for the comfort of the patient can also lead to errors on billing. Let me give you an example. I have worked in a variety of care setting as I have said. This takes place in a Neonatal ICU. There we would put fleece squares in the bottom of the isolette to prevent skin breakdown.
It just so happened that the fleece square affected the x-rays on some of the babes. In some cases the x-ray appeared more patchy, it had more white space. So unintentionally this comfort measure was actually counter productive. A clever physician figured out the cause and it was quickly remedied.
Billing errors are common on hospital and medical bills. And as I have described above some of these overcharges are the result human error inputing the charges. Part II however deals with a different sort of problem.
