These Six ‘Misconceptions’ Could Seriously Impact Your Hospital Bill
Nobody wants to go to the hospital. When you’re in the hospital, you’re either sick, injured, or visiting someone who is sick or injured. More than 34 million people are admitted to hospitals each year, and these hospitalizations are expensive : the average daily cost is more than $2,800 . With the average hospital stay being 4.5 days, or nearly $13,000, it’s important to understand all aspects of the care you’re paying for.
Doctors , nurses, and other staff at any hospital undoubtedly want to provide you with the best care possible—that’s why they chose this profession. But hospitals aren’t just places to get treatment; they’re large, growing businesses. And like any large, growing business, communication isn’t always perfect, and miscommunication and misunderstandings can lead to higher bills and unnecessary expenses.
The “Necessity” of Prepayments
It’s becoming increasingly common for you to be asked to pay in advance, either partially or in full, when you go to a hospital for a planned operation or procedure. This is often accompanied by pressure and intimidation: you may be taken into a room with a hospital staff member who will discuss the cost and ask how much you are willing to pay up front. The implication is that you will have to pay something if you want to receive care, but you will almost certainly not have to pay anything up front. The hospital may be happy to let you think you are doing this. But this is a bad idea for one simple reason: your final bill may be much lower than expected, and getting your money back is never easy.
Unnecessary procedures
Different hospital systems have different models for paying physicians, most of which combine a base salary with various incentives. Sometimes, this model can encourage physicians to perform procedures, tests, or even surgeries that are not absolutely necessary but are usually presented as routine activities that simply must be performed. Even other models that adjust compensation based on the time, skill required, and resources expended during a procedure can encourage physicians to perform unnecessary actions in order to earn higher salaries.
Likewise, doctors are often happy to book appointments with specialists, especially if you have concerns or questions—and that’s fine, as long as those specialists don’t show up at your bedside every day in the hospital, unnecessarily running up your bill. It never hurts to ask your doctor if there’s anything you need or if there are cheaper alternatives worth considering. And if a specialist just pops in to say hello and ask how you’re doing, consider whether it’s worth the effort to keep coming back.
Reception versus observation
You might think that if you stay in the hospital overnight, you’re already admitted. But “hospitalization” is a specific instance where you’re in the hospital under the care of a doctor. You may be in the hospital under “observation,” which means you’re considered an outpatient even while you’re in the hospital. Hospital staff may not clarify your status, and it can significantly impact your insurance coverage, so it’s important to know for sure.
Medicines
Hospitals often make a big fuss about medications you bring from home. Their concerns are well-founded: They need to know about every drug you take, even supposedly harmless ones like over-the-counter painkillers, to avoid dangerous interactions and other complications. You might think that these medications can only be purchased at the hospital pharmacy, usually at a huge markup — and when we say “huge,” we mean $500 for a single Tylenol — but you could be wrong. You can often bring your own medications, but you’ll need to check with your doctor and get permission to do so. The hospital pharmacy may also require that you check your supply to make sure everything is in order.
Emergency Room vs. Outpatient Department
The emergence of urgent care centers offers an alternative to hospitals and emergency rooms. Urgent care centers are generally cheaper and less crowded, so they can be a viable alternative to a hospital if you have a non-emergency or serious condition and want to save time and money.
Unless the emergency room is in a hospital outpatient department (HOPD). HOPDs often resemble urgent care centers, but are technically part of the hospital that runs them, and so charge hospital rates for everything. It’s easy to walk into a store thinking you’re in the emergency room, only to find out when you get your bill that you were charged hospital rates.
Price lists
Hospitals are now required to publish clear price lists for services and procedures, but these price lists are often outright fictitious. Patients sometimes find that the prices on their hospital bill do not match the published price list , or that many charges are not listed publicly at all. It is a good idea to review the price list before going to the hospital for a procedure to estimate your costs. But you should review the list again after receiving your bill – never assume that they will match.