The ‘Itemized Bill’ hack for lowering pricey hospital bills is going viral. TikTok user @shaunnaburns3 recommended anyone with a pricey hospital bill call their hospital's billing department and ask for an itemized list of what exactly they're being charged. Asking for an itemized receipt will prompt the billing department to review everything they charged a patient for and remove charges a patient could dispute if they spotted them in the bill. The thread soon became a way for others to share their own successes with the genius trick. However, sometimes, an itemized bill is not enough to lower your bill.
Recently I got a bill from Urgent Care about my phenomena visit, where I received an X-ray, lab test, and consultation with the doctor. The bill came to a total of $600. I knew I had to dispute the bill, so I asked for an itemized bill. One charge that stood out was $300 for “New Patient Level 4”. After calling the Urgent Care facility, each giving different answers or pushing back for my suspicion about the charge, I decided that taking people by their word wasn’t working. Some receptionists stated that $300 was merely a flat fee for entering the facility, while others said that this charge came from speaking to the doctor.
Although TikTok’s advice was a good starting point, I came up with the idea to use the knowledge from my Data Analytics in Health class to figure this out. Something that stuck out from the curriculum to me was ICD-10 codes: a universal system physicians use to classify and code all diagnoses, symptoms and procedures for claims processing. ICD-10 codes are passed to insurance companies to establish the medical necessity of the services a provider is asking to be paid for. There are more than 70,000 of them, and their highly specific definitions are understood by all who use them.
ICD-10 codes are universal, but the cost of services differs from facility to facility. After researching the ICD-10 code and description for “New Patient Level 4”, I learned that the service I was charged for was a 45+ minute consultation. With my new knowledge, I wanted to appeal the charge, given that I was only there for 10 minutes. I found that something like “New Patient Level 1” was more appropriate for my case. The price of “New Patient Level 1” for the particular urgent care I came to was no more than $50 (unlike the original $300 I was being charged).
So here are your tips for the day:
1. Itemize your bills - this is how you can find out if you’re being charged absurd amounts for things like toothbrushes or services you were never given
2. Research the ICD-10 codes of the services - this should be your second resort if an itemized bill does not work.
3. Do not spend unnecessary time in healthcare facilities - they will charge extra for things that.
4. Use your knowledge from Bentley classes - being a business school, all of our classes are meant to help us in the real world, especially financially.