Medical-bill errors becoming more common (Sure, but why are they never in MY favor?)

Source: AP

That's what I have always wanted to understand: from cable tv, to banks, to utility companies, to medical services they are virtually always in the companies favor. Something weird going on here.

Read more: http://www.msnbc.msn.com/id/21527433/

who do you thing they will favor?

After receiving some strange looking bills from a trip to the Emergency Room at my local hospital, I called the billing office and -- surprise!! -- actually spoke to someone who knew what she was doing.

She said I had overpaid and was due a refund, and furthermore, not to pay any more bills without talking to her first.

they can easily pad a bill and no one will catch the extra "this and that" that was never delivered...

just like the voting machine errors.

expect them to keep making it.

If you profit form a mistake, that's costing them money. They'll track it down and demand that you pay them every penny of it, usually with an attitude that implies that you committed fraud and tried to steal from them.

Any "mistakes" that survive for long in that system will always favor them.

I mean seriously -- when was the last time you counted up the meds you received in a hospital stay or actually tracked your electric/gas meter?

They are playing the odds that no one catches it, and if they do, well 1 refund out of 10 overcharges (I made that ratio up) isn't bad, it is profitable.

I can say that the business rules for billing are extremely complicated and often conflicted. It's not at all surprising that they aren't always right. The insurance companies have billing rules that are constantly changing (getting more complicated), and the medicare rules are complex.

As far as whether they favor the company vs the consumer, I was always more concerned with introducing an underbilling mistake because I know that underbilling bugs will rarely be caught if not by our testing (who reports that a $35,000 hospital bill is too low?), while an overbilling bug will be reported very quickly. Given a limited amount of time and resources, it's natural to pay a little more attention to making sure it doesn't underbill.

and every single time the error is in the insurance company's favor.

I have learned the insurance company's sneaky little ways to get out of paying a valid bill, so I make sure I get all the required referrals and reauthorizations. But even when I follow their very confusing preauthorizations, they bill it wrong. Eventually they pay it but only after at least five phone calls.

:sarcasm:

Sorry, I couldn't resist. Anybody who thinks that corporate America is 'better' than the government at improving 'efficiency' hasn't worked in or dealt with corporate America.

:shrug: