How to Cut Your Hospital Bills

Even if you have health insurance, being hospitalized can cost you hundreds, if not thousands, of dollars. Although you may not be able to avoid a hospital stay, there are ways to trim the expenses.

Knowing how to reduce your medical bills is especially important if you are in a consumer-directed health plan, such as a medical savings account. These plans place more responsibility for health care decisions on your shoulders.

Before your stay

• Be sure you understand your health insurance policy. Read your manual and updates as they arrive. Ask your supervisor or employee-benefits staff to explain any requirement you find confusing. For example: You could be liable for 50 percent of the costs if your policy requires pre-approval and a second opinion for surgery and you don't comply.

• Find out if you have to submit the bills to the insurance company or if your doctor's office and hospital will submit them.

• Ask your doctor if routine tests can be done before you're hospitalized. For example, it's less expensive to have blood tests and chest X-rays done as an outpatient.

• Pay attention to check-in and checkout times. Save the cost of an extra night's stay by checking in the day of your procedure.

• Find out if the hospital has progressive care, or step-down units, in which healthier patients receive a reduced level of care at a cost savings.

• Get as much of your treatment pre-approved by your health insurance representative as possible. You won't have to fight for coverage afterward.

• Ask your doctor to inform you of all visits by other doctors, and ask whether the visits are necessary for your recovery, because you'll be billed for them. Many hospitals use "hospitalists" now -- doctors who only see hospital patients; your own doctor may never see you in the hospital. Make sure the hospital doctor knows who you are (so he or she doesn't mistake you for another patient).

• Avoid weekend and holiday admissions. Unless your surgery is an emergency, you'll receive little or no medical care but will still be billed for your room.

When you check out

Check your bill as soon as you can after you are discharged. To keep from being overcharged, ask for a detailed, itemized invoice. You don't necessarily need to review your bill before you leave the hospital. You may not feel well when leaving, and you shouldn't be making financial decisions then. You have time to dispute any questionable charges.

Be on the lookout for:

• Drugs or supplies not provided. For example, make sure you're not billed for medications to take at home that you did not accept.

• Services not provided. For example, your doctor may have ordered a test, then canceled it, or you may have been scheduled for 10 treatments from physical, speech or other therapists but received only eight.

• "Phantom" charges. Hospitals often bundle common procedures into packages that include a standard set of services, all of which are billed to patients. For example, even if you didn't use the delivery room or anesthesia when delivering a baby, the hospital may bill you for them.

• Duplicate billings for the same test or procedure.

• Inconsistencies. A test that cost $50 on Monday shouldn't cost $100 on Friday.

Correcting errors

Call the hospital accounting office and request an adjustment for any errors. If you have difficulty resolving your complaint, talk with your insurance company, employee-benefits department or your state's Department of Consumer Affairs.