Hundreds of tri-state residents get medical bills containing errors each year, unwittingly paying extra out of pocket or potentially exposing themselves to legal action if they don't settle the accounts, an I-Team investigation has found.
Bob Currao, for one, opened an AARP/Medicare invoice to find blood work, urine samples and inpatient care he says he never received. The Connecticut man said the invoice had three trips between February and March to the same doctor -- a Dr. Michael Frank in New York City.
Currao had never heard of him.
Currao reported the confusion to his insurer, UnitedHealthcare, which acknowledged the error.
"After a thorough investigation and with the cooperation of the doctor who provided the services in questions, we have determined that this incident resulted from an error on the part of the doctor’s staff,” UnitedHealthcare spokeswoman Sarah Bearce told the I-Team in a statement.
In this case, a difference of just one number caused the claim to be processed in Currao’s name, the I-Team found.
Nationwide, one in 10 medical bills contains a claims error, according to the American Medical Association. The Access Project, a Boston-based health care advocacy group, says it happens 80 percent of the time.
But policy holders who don't take care of an invoice, if one in error, could face problems.
“If you don't settle it, they could take legal action," said Sheila Pope, a medical billing expert with MD Bills, which helps patients organize, understand and save money on their medical bills.
Pope is a health care advocate whose company helps patients find errors in their bills. She says it is more important than ever to be vigilant about what your doctor or hospital is charging you.
“With more physician offices and hospitals adopting electronic billing, there’s a bigger chance of errors,” Pope said.
Those billing errors could mean a lot of money out of your pocket, though exact figures on how much they amount to in a given year are not available.
The New York State Attorney General, which runs a help line to assist patients with billing problems, said that last year, it helped return nearly $300,000 to consumers who were affected by improper billing. It helped return $21,000 in cases where providers entered a wrong amount or code, $27,000 in cases where providers did not submit a claim to the insurance company and more than $3,000 in cases of improper late fees, finance charges or missed appointment fees.
In consulting with consumers, Pope says she has seen offices billing patients twice for the same service or improperly charging for extra services. Failure to be vigilant could contribute to increased costs down the road.
Currao knows how crucial it is to be mindful.
“When you sense something is going on like this, you need to act on it as soon and as quickly as possible and be your own advocate in clearing it up,” he said.
Experts tell the I-Team consumers should review their statements carefully.
Here are a few tips for catching common billing errors:
- Look at the bills as they come in because the longer you wait, the harder it is to fix an error
- Ask your provider for a detailed bill for that visit or procedure to help you find anything that doesn’t seem right
- Make sure your insurance benefits match the charges from your doctor. There is a chance you were billed for something that should have been covered by your health care plan