Hospital-payer billing errors abound

Billing between hospitals and payers is often riddled with errors, creating a confusing situation as to how much healthcare delivery actually costs, reported The Plain Dealer.

Up to 40 percent of claims between providers and payers contain mistakes, according to Stephen Parente, a professor of health finance and insurance at the University of Minnesota.

"Somebody didn't put on the right diagnosis code or didn't put on a diagnosis code at all," Parente told the Plain Dealer, citing an analysis he undertook.

Partly as a result, consumers may be hit with higher bills than expected, despite laws in states such as Ohio that attempt to add clarity to healthcare pricing. For example, the newspaper cited a "facility fee," which some hospitals charge but are not always clearly delineated in the bills they issue.

Among Ohio providers, the trend can be exacerbated when hospitals try to collect on nominal amounts rather than providing charity care. That was the case with Mount Carmel Health System in Columbus, which charged an outpatient $1,800 for prenatal services even though she likely qualified for charity care, and then sued her, according to Kaiser Health News.

For more:
- read the Plain Dealer article
- here's the Kaiser Health News article

Suggested Articles

Presidential candidate Kamala Harris wants to get rid of the tax break drug companies get for DTC ads

Healthcare software company Phreesia closed its first day of trading as a public company Thursday about 40% above its set price.

Growing the biosimilar market could lead to significant healthcare cost savings, according to a new report.