Hospital bills, errors, colonoscopies among Philly’s biggest health cost concerns
Prices are arbitrary
We launched the Philly Health Costs project on the premise that prices for even basic services, like blood tests and x-rays, . As out-of-pocket costs continue to rise, it’s increasingly important for people to be able to know in advance what something will cost -- but it’s virtually impossible to get answers. This turned out to be overwhelmingly true in the
Prices are difficult to find out in advance and impossible for anyone to explain after the fact. Patients who call providers to inquire about cost are told that information is proprietary or that they should check with the insurance company. Insurers also struggle to give exact numbers, since the amount you owe will depend on what exactly the provider bills for, how much of your plan’s deductible you’ve already paid and whether there are other cost-sharing terms in your plan. Online price estimator tools can sometimes give a ballpark, but even when people use these, they can end up with a bill that’s out of the stadium. That’s what happened to
Billing errors are common and hard to get fixed
Analysts estimate that as many as one in five medical bills contain a mistake, yet it’s incredibly difficult for patients to get mistakes corrected.
Routine procedures, like colonoscopies and , are particularly susceptible to billing errors. Under the Affordable Care Act, certain preventive tests are supposed to be covered in full by insurance, without any additional copay or bill to the patient. A , for example, should be covered fully for adults age 50 and older who meet all other guidelines for a screening and are at average risk of colon cancer -- even if a polyp is removed. But based on the many, many emails I’ve received from frustrated readers, providers routinely switch the procedure code to a diagnostic colonoscopy if they snip a polyp and patients get billed accordingly.
Being vocal can pay off
Many of the people who have been featured in my stories brought their problem to me after getting nowhere on their own. And sometimes, a little publicity can help move things along.
Corporate communication needs work
Insurance companies and health systems need to do a better job of communicating with people. Typically people bring their bills to me once they feel they’ve exhausted all their options -- they’ve called their insurer and the hospital numerous times and been unable to get an answer to their question. When I talk to insurers and hospitals, they point to their online price tools, plan coverage descriptions on their websites, financial support departments that are there to answer questions, but it’s clear these resources aren’t enough. People are showing a deep interest in the cost of health care and these major players are missing an opportunity to meaningfully engage with their members in a way that could actually help reduce their overall health care spending.
Damaged credit is a real fear
People are very concerned about medical debt affecting their credit rating. Often they try to challenge a medical bill, but in the meantime they keep getting notices and end up paying it because they receive a “last reminder” notice telling them this is their final opportunity to pay before it’s sent to collections. FICO, the most commonly used credit agency, has to lessen the impact of medical debt on credit rating. But banks and lending institutions may be using older software versions that still count medical debt like any other delinquent bill.
Health costs are toxic
The high cost of health care is affecting our health. When people can’t afford to pay or have a negative experience with a provider, they’re more likely to skip important medications, procedures and preventive tests. We’ve heard about and people with diabetes who are rationing their medication or entirely -- an incredibly dangerous way to save money. I recently wrote about a
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