Medical Billing Problems Part I
Tuesday, September 30th, 2008Let’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.
Mistakes happen, that is part of life. And sometimes when we try the hardest we make the most. The same applies to entering orders. A wrong test is ordered, or wrong date or not in proper time sequence. It could happen and it does happen.
I know I have been called by the lab and radiology and even dietary asking about an order in the computer. Just the other day I was called by lab and asked if I wanted the magnesium level drawn now even though one was done earlier in the morning. Since there was no order I said no.
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 supplies are another story altogether. This happened to me recently, I was caring for two sick patients. I was busy running from room to room giving the proper care. When I did sit down my uniform top was covered with stickers from the supplies I had used.
When it was time to affix the stickers to the “charge cards” I had to remember which sticker and corresponding supply I used for which patient. I am sure I did just that, but with the acuity of patients nowadays and the hectic work load stickers can be misplaced.
Even well intentioned actions intended for comfort of the patients can lead to unforeseen consequences. As I have said I have worked in a variety of care setting. This example took place in the Neonatal ICU. There we routinely put small 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.
Billing errors are common on hospital and medical bills. And as I have described above some of these overcharges are the result human error inputing the charges. Part II however deals with a different sort of problem.
If you're new here, you may want to subscribe to my RSS feed. Thanks for visiting!