C.D. Smith Investigations

Don't let hospital billing departments pull these -- like charging you for two appendectomies -- on you. It's an outrage.

Make no mistake about it: Making sure that all the charges on your hospital bill are justified and reasonable is a formidable undertaking. But it can be easier if you know what to look for.

Here are the most common areas of overcharges and errors, plus what to do if you find irregularities.

Duplicate billing: Make sure you haven't been charged twice for the same service, supplies or medications.

Number of days in hospital: Check the dates of your admission and discharge. Were you charged for the discharge day? Most hospitals will charge for admission day, but not for day of discharge.

Incorrect room charges: If you were in a semi-private room, make sure you're not being charged for a private.

Operating-room time: It's not uncommon for hospitals to bill for more time than you actually used. Compare the charge with your anesthesiologist's records.

Up coding: Hospitals often shift the charge for a lower-cost service or medication to one that's more costly. For example, a doctor orders a generic drug, but the patient is charged for a pricier brand name.

Keystroke error: A computer operator accidentally hits the wrong key on a keyboard. It can cost you hundreds of dollars and result in an incorrect charge for a service you didn't get.

Canceled work: Your physician ordered an expensive test and then canceled it, but you were charged anyway.

Services never rendered: Did you get every service, treatment and medication for which you are being billed? Here's where your log will come in handy.

Professional bill reviewers can help
If you find errors, contact your provider's billing office and your insurer. If they are of no help and the discrepancies are significant, you may want to turn to trained professionals who will help you analyze the bill and negotiate for you.

"These professionals have sprung up because there are so many errors," says Bill Mahon of the National Health Care Anti-Fraud Association. "They are saving people money, and sometimes it's a lot of money."

Medical Billing Advocates of America is one of them. Based in Salem, Va., it operates in 18 states and the District of Columbia. These firms frequently work on a contingency basis, meaning they get paid a percentage of the amount they save you. But that percentage often runs as high as 50%, so make sure you understand their charges before you put them to work. Click on "Find An Advocate" on the home page. 

You can find others if you do an Internet search under "hospital bill review."

You can also get help from the consumer protection office of your state's attorney general.