Watch Out for This When You Go to the Hospital

In this day and age where prices of almost everything from groceries to real estate continue to climb, it is important to realize that one of the most critical areas for individuals to monitor is their medical expenses.

Everyone, at some time in their lives will need some type of hospitalization and/ or outpatient care, and it is very easy for expenses to increase rapidly for even the most minor of illnesses and accidents. "Such inflated practices continue to price far too many Americans out of access to needed medical care or expose them to financial ruin. It's long past time to rein in the price gouging and recognize that a healthcare system based on profiteering puts all of us at risk," Jean Ross, co-president of National Nurses United, said in a press release. Knowing what to look for and analyze as well as looking at other medical alternatives will help keep money in your wallet. Here are three ways a routine hospital visit can put a hole in your wallet and how you can avoid outrageous medical bills.

1. The "Observation" Status Trap

In years past, if you spent the night in a hospital you were automatically considered an inpatient. Now there are three levels of care which hospitals use to designate patients: outpatient, inpatient care, and observation. An "observation" patient is never actually admitted but may spend 24 to 48 hours or more in the facility until they are released. What "observation" level patients need to understand is that if they are not formally admitted, they may be subject to many expenses that Medicare or private health insurance will not cover. If you are not formally admitted to a hospital, any medicine or necessary drugs given to you may not be covered. For example, an "observation" level patient from Florida said that her hospital charged $71 for one blood pressure pill for which her neighborhood pharmacy charges 16 cents. The medicine was not covered by her insurance because she was never "admitted" into the hospital.

Some hospitals will not allow patients to bring their own medications. Also if a patient needs follow-up care in a nursing home, the insurance may refuse to cover the nursing home stay.

Solution: Know and Understand Your Patient Status

To assist with this and similar situations, individuals need to question their patient status if they are in the hospital, especially if it is only for a few days. If they find that they are considered to be in "observation" care, they then can ask their personal physicians to advocate for them. Terry Berthelot, a senior attorney at the Center for Medicare Advocacy, suggests "asking your regular physician to speak with the doctor treating you in the hospital about why you need to be admitted, based on your medical condition and risk factors."

2. Hospital Billing Errors

According to Medical Billing Advocates of America, 8 out of 10 hospital bills contain a mistake. It happens more often than you might expect and medical billing errors could result in you getting overcharged or in other words "ripped-off".

Solution: Review Hospital and Outpatient Bills

It is up to you to ask for detailed copies of all of your expenses after your visit or stay. Question any entries that you do not understand and appeal any costs that you feel are unnecessary or inflated. If your costs are significant, it may also be well worth your time to hire a specialist to examine all charges for accuracy.

3. Emergency Room Bills

The average charge for an emergency room trip cost about $1,233 and the cost is rising at an alarming rate. In a life-threatening medical situation, it's important to go straight to the hospital emergency room. However, several studies have found that majority of emergency room visits made by patients are for minor injuries or illnesses that do not require immediate attention in the emergency room. Many of these non-emergency illnesses could be treated by a doctor at an urgent care clinic for a fraction of what hospitals charge.

Solution: Use Urgent Care

Urgent care facilities are far less expensive than a hospital emergency room so if your condition or that of a family member is not serious, you may wish to consider this viable alternative. According to the National Institutes of Health (NIH), "a visit to the ER can cost two to three times more on average than a visit to an urgent care clinic for the same injury or illness." Not only will your expenses be far less but your wait time will also be cut dramatically. With the number of new urgent care facilities opening up and clamoring for your business, wait times are advertised as minimal at many locations to entice new and return patients to use their quick and convenient services. Consider visiting an urgent care clinic for non-emergency symptoms such as ear pain, headache nausea, dizziness, sprains, and minor cuts.

NOTE: If symptoms are serious, patients should go directly to the emergency room where they will be better equipped and staffed to handle the situation. Severe symptoms may include chest pains, paralysis, severe bleeding, and poisoning or neck injuries.

Be Aware!

The most important aspect of monitoring your medical care is to be aware. Ask for a copy of your bill, question your patient status, ask about the cost of drugs, appeal decisions that appear to be incorrect and hire professional assistance when you feel that you have been charged excessively. Taking an active and even a proactive part in managing expenses will keep you from paying bills that are incorrect or inflated.

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