You've likely experienced it. You go to your doctor because you are ill. Your doctor diagnoses you and provides you with treatment. Everything seems reasonable and clear until you get your bill. That medical bill, however, is a list of codes, word snippets and charges you find difficult to understand.
Medical Charge Puzzle
Think of the last time you put together a puzzle. Now, imagine that each piece is completely uniform and the only way to put the puzzle together is to label each piece accurately according to its position in the overall picture. Each piece's label defines its individual price. Further, if a piece is not labeled, it gets thrown away forever, which sounds beneficial for the person who must pay for the pieces. That unlabeled piece, however, may be critical to the identification of the overall picture, which defines if bulk discounts or even free services apply. This weird puzzle exercise is a reality every day for individuals and medical professionals alike and is a driving reason why many medial providers use charge capture services.
Written for Insurance Companies Not Patients
A stark reality is that medical bills are written for insurance companies and not patients, yet what is or is not included on a medical bill can deeply impact a patient. In order to understand the medical services for which they must pay, patients need to understand their bills. Unfortunately, a patient-friendly version of a medical bill does not currently exist, so patients must work with their medical professionals and insurance companies to decipher a bill to advocate on their own behalf.
Hopefully, the future will bring a more patient-centric practice to medical billing. For now, the puzzles remain for both patients and medical professionals, and the best path is to review each line-item of your medical bill carefully and ask your medical professional or insurance provider for clarification where needed.
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