Medical Billing Problems Part I
Let’s do a quick review; most items that appear on your hospital bill first originate as a physician’s order. The computer stores the order and billing is carried out. For supplies the patient is charged by various methods including stickers transfered from the item used to the “charge card”.
You don’t have to go far in these days to find outlandish hospital and medical bills. Millions upon millions of hospital overcharges are billed. In Part I we will take a closer look at human error.
Everyone makes mistakes and that happens when entering orders as well. Perhaps the date is wrong or the test is not exactly what the physician ordered. In short, anything could and probably does happen.
From personal experience I can tell you I have been called by lab, radiology, pharmacy and even dietary questioning about an order in the computer. Fortunately not all in the same day on the same patient. Just recently lab called about an order, a magnesium was scheduled to be drawn even though one had been done earlier in the morning. Since there was no order, I canceled the new one.
Safety of the patient isn’t compromised purely waiting for an order. So the service is rendered first and then an order is put in, most times the department will remind you to do so. So a stat x-ray can be completed with the promise of an order later.
And when the situation has calmed is an order placed? Well certainly that is the goal to charge for services rendered, but in reality sometimes it is missed.
Other safe guards are in place also, for instance hospitals may require doctors to enter their own orders into the computer. This eliminates several steps and presumably would cut down errors. Nurses routinely do chart checks to make sure the orders are noted and correct.
And remember those stickers and supplies? I can give you a personal example, this happened a few nights ago. I had two sick patients and I was very busy running from room to room giving care. At the end of the shift I had sticker all over my uniform top from the supplies I had used.
So to make things right I had to put the proper sticker on the proper “charge card”. I think I did just that, but with the hectic work load stickers maybe misplaced.
Something simple intended for the comfort of the patient can also lead to errors on billing. Let me give you an example. I have worked in a variety of care setting as I have said. This takes place in a Neonatal ICU. There we would put fleece squares in the bottom of the isolette to prevent skin breakdown.
It just so happened that the fleece square affected the x-rays on some of the babes. In some cases the x-ray appeared more patchy, it had more white space. So unintentionally this comfort measure was actually counter productive. A clever physician figured out the cause and it was quickly remedied.
So I hope you can see how human error can contribute to hospital and medical bill errors. I have given several examples how they may occur. The next part will deal with a different kind of error however.
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