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Understanding your hospital bill

If you have been in the hospital, you will receive a bill listing the charges. Hospital bills can be complex and confusing. While it may seem hard to do, you should look closely at the bill and ask questions if you see something you do not understand.

Here are some tips for reading your hospital bill and suggestions for what to do if you find an error. Looking closely at your bill may help you save money.

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Charges Listed on Your Hospital Bill

A hospital bill will list the major charges from your visit. It lists the services you received (such as procedures and tests), as well as medicines and supplies. Most of time, you will get a separate bill for health care provider fees. It is a good idea to ask for a more detailed hospital bill with all of the charges described separately. That can help you make sure the bill is correct.

If you have insurance, you may also get a form from your insurance company, called an Explanation of Benefits (EOB). This is not a bill. It explains:

A deductible is the amount of money you must pay each year to cover your medical care expenses before your insurance policy starts to pay. Coinsurance is the amount you pay for medical care after you have met your health insurance deductible. It is often given as a percentage.

The information on the EOB should match your hospital bill. If it does not, or there is something you do not understand, call your insurance company.

Check Your Charges

Errors on your medical bill can cost you money. So it is worth the time to check your bill. Check the following items carefully:

A Fair Price

If you had surgery or another procedure, it helps to know whether your hospital charged a fair price. There are some websites you can use to help you find this information. They use national databases of billed medical services. You enter the name of the procedure and your zip code to find an average or estimated price in your area.

If the charge on your bill is higher than the fair price or higher than what other hospitals charge, you can use the information to ask for a lower fee.

Ask Questions

If you do not understand a charge on your bill, many hospitals have financial counselors to help you with your bill. They can help explain the bill in clear language. If you find a mistake, ask the billing department to correct the error. Keep a record of the date and time you called, the name of the person you spoke to, and what you were told.

If you find an error and do not feel you are getting the help you need, consider hiring a medical-billing advocate. Advocates charge an hourly fee or a percentage of the amount of money you save as a result of their review.

Get Help Paying Your Bill

If you cannot pay your bill in full before the due date, you may have options. Ask the hospital billing department if you can:

References

American Academy of Family Physicians. Understanding your medical bills. familydoctor.org/understanding-your-medical-bills. Updated February 27, 2018. Accessed August 13, 2018.

American Hospital Association website. AHA policies & guidelines on billing, collections, tax-exempt status, and community health. www.aha.org/system/files/content/00-10/07nov-billingpolicyguidelines.pdf. Updated May 5, 2012. Accessed August 13, 2018.

FAIR Health Consumer website. Understanding your medical bill. www.fairhealthconsumer.org/insurance-basics/your-bill/how-to-review-your-medical-bill. Accessed August 13, 2018.

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Review Date: 8/3/2018  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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