Tuesday, August 19, 2008

HIPAA Craziness

I received a bill for my day at the ER room back in July. The biggest line item was "MRI - GENERAL" for $5,150. Since Hoag Hospital messed up and scanned my leg twice, I wanted to make sure that I (and Broadcom's self-funded health insurance) wasn't billed incorrectly. Also, my part of the co-pay was ~$100. After waiting for 10 minutes, I finally talked to a CSR. However, she could not see more information on my bill because of HIPAA; she can only order a detailed billing statement to be sent by snail mail. I then asked her who I should talk to if there is an incorrect billing since no one can see details on a computer screen. The answer was that I have to write a dispute letter and mail it in.

Even worse, both scans were read by radiologists from another medical group and they billed me for both MRI's as well. I called them up too and the first response I got was, "The original bill was over $700 and insurance is paying most of it. Your co-pay is only $50." I guess the implication was why I was complaining about the bill since insurance paid for most of it.

Sigh... this is probably going to drag on for awhile. Leon said I was being Chinese, i.e., cheap, and he's probably right. I'll end up spending hours more on the phone and writing this dispute letter for ~$60. With insurance, there's really no real incentive for me to follow up; it's easier just to pay the relatively small co-pay. Since our company's health insurance is self-funded, there's also no incentive for Aetna, who administrates our plan, to be diligent in verifying bills. I wonder how much of the $60M we spend each year on healthcare costs is billing errors.

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