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How you can better understand your medical bills so you're not overcharged

Posted: 6:00 AM, May 11, 2017
Updated: 2017-05-12 18:01:04Z

Patients in our area and around the country are paying too much for their medical bills.

Billing errors, overcharges and double-billing are racking up thousands in unsubstantiated costs.

A local case

"I get that bill again and my heart rate goes up and I'm like, 'you've got to be kidding me,'" said Cindy Crock of Massillon. "Why won't somebody fix this?"

She's seen piles of medical bills, some with threats, after C-sections and other medical procedures.

"We have paid over $30,000 out of pocket for a lot of these things over the years,” Crock said.

So does she even know what she's paying for? 

“I have no idea what half of it is,” she said.

Most recently, there was an emergency room bill for her son.

“It's very frustrating,” she told News 5.

Outrageous charges

"A lot of times the billing department doesn't even know what these charges are,” said medical bill expert Pat Willis. She is from Northeast Ohio and is the owner of MD Bill Advocate. She's hired by patients to look through medical bills and find errors.

“$118,000 and I got it down 50 percent,” said Willis who showed News 5 a bill from this year. There was another bill right next to it for $16,000.

“After the review, it was $7,500," she said.

She picked out things like:

  • Q-tips - $23 each
  • Tylenol - $15 per pill
  • Non-sterile latex gloves - $53
  • Pitcher of water - $2.75
  • "Cough support device" (a teddy bear) - $57

"They write it ‘cough support system’ so you think you're really getting something,” Willis said.

And you'll spend $10 every time a person hands you medication.

"Hospitals are allowed to charge whatever they want to. That's what's sad,” said Willis. “There are rules and regulations and guidelines to follow. They're not made to.  They don't have to.”

So why is that? 

“That's a good question."

Getting ripped off

Why do we often feel like we're getting ripped off? Well, one reason is that even the thing that's supposed to simplify all this isn't used or enforced.

The U.S. Department of Health and Human Services said there are rates called UCRs that the medical industry is supposed to follow. But Willis said they're ignored. In fact, she said out of all the bills she’s gone over and helped people with, there's only been one that's had a UCR adjustment on it.

She's been doing this for 10 years, looking over hundreds of bills from across the country and making thousands of phone calls. She even showed News 5 the huge books just from this year that Willis has had to use to keep up with medical billing.

"The different way they're doing the bills. That's why I have to keep going to classes and stuff because they're changing things constantly. And it's like, 'Oh, my gosh. Now what?'" she said.

There have been class-action lawsuits about medical billing including one out of Akron recently where there were issues with “inflating and manipulating” billing statements.

Even U.S. Senator Sherrod Brown from Ohio, who's active with medical issues and is vocal about Obamacare, has a hard time explaining why billing can be bad.

"The payers and the government struggled for years on how to bring more fairness to the system,” said Brown. “It's so complicated because we've allowed our health care system to get so complicated."

How to better understand your bills

We know sometimes it doesn't feel quite right to ask your doctor or the staff, but this is where we are with in healthcare these days.

Prior to your medical procedure, get an estimated itemized bill and get it in writing with the hospital employee's name and the date.

Ask for itemized bills after the procedure not just summaries with little information.

Plus, you can check the costs on Fairhealthconsumer.org or Healthcarebluebook.com . Both organizations have collected data on medical pricing from across the country.

".... And to be honest, I really don't even know what the emergency room bill entails,” Crock told News 5. 

She suggested medical facilities should assign an employee to follow a patient through their entire procedure to make sure itemized bills are correct.

"If you don't have the staff to do it, then hire the staff to do that because I know I'm not the only person who's been through this,” she said.