r/HospitalBills • u/fuckmissbrixil • 1d ago

"ask for an itemized bill" doesn't work

So this happened two years ago and has since been paid off, though it took about eight months to fully pay off the debt, so I'm not looking for what to do. I wanted to share my experience.

I got an ER bill that was $2463 due out of pocket AFTER insurance covered it

I didn't need to ask for an itemized bill because they had already provided one when they first sent the bill.

When I looked through the bill, I got charged just for having a UTI! I don't mean I was charged for the antibiotics, (although there was of course a charge for that too under "medication" charges) but there was literally a separate "miscellaneous" charge that just said something like "urinary tract infection" which is what I had. It was hundreds of dollars. They had charged me hundreds of dollars just for having a UTI. Which I didn't even know I had because it was asymptomatic and was completely unrelated to the reason I was there :/

38 Upvotes

64% Upvoted

50 comments sorted by

19

u/Ok-Seaworthiness-542 1d ago

They didn’t charge you for having a UTI, it's likely a diagnostic code.

Also, what do you mean it doesn't work to ask for an itemized bill?

10

u/Jassyladd311 1d ago

Hospitals have gotten smarter and just send out an itemized bill to begin with. You cant itemize a bill that's already itemized.

5

u/themagicflutist 20h ago

The times I have asked for itemized, no one could do it. Maybe I go to the dumb hospitals lol

3

u/lrkt88 9h ago

Billing has changed a lot. Much of it just isn’t itemized, especially for hospitals. For example, a per diem inpatient fee will cover many things.

5

u/fuckmissbrixil 1d ago

So the diagnostic codes are listed on the bill and have a hundreds price tag next to it?

15

u/Leading-Reference-31 1d ago

They mean the diagnostic test to conclude that you had a UTI. Every charge has a code attached to it when the claim is generated, they can't and don't charge you for having a UTI. There was a service.

4

u/Charigot 1d ago

But what “doesn’t work” — did you think asking for an itemized bill would make them lower the bill? I’m confused about what you expected it to do that it did not.

2

u/fuckmissbrixil 1d ago

No I'm saying the viral hack "ask for an itemized bill to see the outrageous charges and try and lower it" doesn't work anymore

6

u/Charigot 1d ago

Asking for an itemized bill is important so you can see if they’ve mistakenly charged you x10 for Tylenol like they did for my husband. It’s not magic or viral - it’s just smart.

2

u/fuckmissbrixil 1d ago

makes sense!

2

u/throwawayeverynight 1d ago

It has never worked lol

1

u/Ok-Seaworthiness-542 18h ago

The point is to see what you were billed for and see if you received those items/services. For example, when I had my appendix removed I didn't have medical insurance. We requested an itemized bill and there were several items I didn't receive because mine was done outpatient. We talked to the hospital and the bill was reduced by 50%

1

u/Joo_Unit 12h ago

Usually when people suggest an itemized bill to get it reduced, its for claims where the person doesn’t have insurance. Where insurance exists, you have already agreed to pay the claim as adjudicated. In that case, you could still catch them billing for a supply or service they didnt perform, or maybe an upcoding of a service (eg: billed you for 45 min provider visit instead of 15). But for this you have to be a savvier healthcare consumer usually.

3

u/ElleGee5152 1d ago

It could have been a lab charge or you were misreading the bill and that actually was the ICD10 diagnosis code. Charges have to have some kind of standardized billing code (CPT, HCPCS or revenue code) assigned and there is no procedure/billing code for "UTI". That's just not a thing.

2

u/fuckmissbrixil 1d ago

Nope, they had separate lab charges

1

u/Witty_Ask_9731 7h ago

I don’t understand your question. “What do you mean it doesn’t work to ask for an itemized bill?”. Did you read what OP wrote. They stated they did get an itemized bill, and (rightfully) were aghast at the charges.

As someone who worked and billed while working in the ER as a student, surely you are not suggesting that insane bills do not occur? I recall billing $100+ for an antibiotic which 1 year later I could purchase at wholesale for less than $1 at a small independent pharmacy.

The cost for a larger organization or buyer group is likely less than a quarter (likely as it has been a couple of years since I was in that role, and basing our cost for metformin #1000 tabs at under $4 vs CVS cost for #30,000 at under $1 after rebates; similar trends occur with antibiotics however this was the drug that stuck with me). There is no way anyone with any actual knowledge of the healthcare system would not empathize with this person, right?

0

u/ilost190pounds 19h ago

When they got one.

26

u/SupermarketSad7504 1d ago

Asking for itemized bills is a total farce. Brings you nothing. Know and understand your insurance benefits.

5

u/Apprehensive-Low3513 1d ago

Asking for itemized bills is a total farce.

Maybe just my experience then, but I asked for an itemized bill and my outstanding amount dropped a ton. Something like $3,000 to $300.

I'm guessing it's only beneficial when your hospital's billing dept is relatively inept.

2

u/Old-Ring-9119 1d ago

I has an itemized bill and found over quantities listed. I pointed it out and my bill was reduced

4

u/rahl07 1d ago

I always ask for one because it's frighteningly common to find duplicate entries. I'm not talking tens of thousands or anything, but I've had like items in the $50-250 price range be duplicated.

2

u/Charigot 1d ago

Yes it’s the only way I discovered they’d charged us $45 for Tylenol with codeine instead of $4.50 — an error they fixed when I called about it.

1

u/throwawayeverynight 1d ago

Most likely they aren’t duplicates just being billed u fee the same revenue code like drugs are

2

u/CapeVincentNY 1d ago

Your insurance is unknowable cause they'll randomly deny things lol

1

u/Beneficial_Heat_7199 10h ago

That's because you're supposed to wait until it goes to collections to ask for it. The collections people don't have access to that information so they can't provide anything.

5

u/No-Produce-6720 1d ago

I'm assuming you're talking about the bill you received from the hospital, not the emergency room doctor. If that's the case, the charge is likely for supplies that are miscellaneous and don't have their own revenue coding. It's not that they charged a blanket fee for a diagnosis on an outpatient visit (although if you were admitted to inpatient, your diagnosis does directly drive billing and reimbursement). Rather, the charge you saw on the claim form was most likely indicative of the supplies used during your visit.

Facility claims are very different from professional claims. I'm happy to explain more in depth, but it can kind of get down in the weeds. It can be really confusing if you don't understand exactly what you're looking at. In your case, though, it sounds as if the billing was correct.

0

u/fuckmissbrixil 1d ago

Yes I was admitted

3

u/Leading-Reference-31 1d ago

Then it's not an ER bill, it's an inpatient bill.

0

u/fuckmissbrixil 1d ago

I wasn't admitted to that hospital. I was transferred to a different hospital. I was in the ER first and I'm talking about the ER bill only.

1

u/Leading-Reference-31 1d ago

Ah, ok in that case yes and ER bill.

1

u/enigmicazn 1d ago

What did you go to the ER for initially?

1

u/Radiant-Ad-9753 1d ago

The number to look at on your benefits card is your max out of pocket. If you are admitted to the hospital, that's the amount you're going to end up paying when everything is settled up.

Trying to line items off the bill won't help when you have an admission and an E.R bill to get below that max OOP amount.

1

u/fuckmissbrixil 1d ago

I was admitted to a different hospital than the ER bill I recieved which is the one in talking about in this post.

1

u/CommunicationNice437 1d ago

Did you dispute it? Ask for more discoubts

1

u/fuckmissbrixil 1d ago

no and this was two years ago and it's been fully paid off since then

1

u/PassengerIcy1039 23h ago

I’m pretty sure you skipped the most important step of the process then. You get an itemized receipt so that you can scrutinize it. It’s not supernatural.

1

u/ElleGee5152 1d ago

In my office (ER provider based billing), an "itemized bill" is exactly the same codes/charges we bill to insurance and send out as regular patient statements. That's as itemized as provider billing gets. What you see is what we billed. It's so hard to get people to understand this because of the internet telling people that asking for an "itemized bill" will magically lower their balance somehow. There are no magic tricks other than learning exactly how your specific health insurance plan works and how those benefits are applied.

1

u/LowParticular8153 22h ago

Itemization is irrelevant when it comes to contract with your insurance company.

Learn about your benefits. A cheaper alternative to emergency room would be an Urgent Care.

1

u/thewebdiva 21h ago

The issue is that the description of the code is not understandable by patients. Having a code labeled UTI means what? Is that the charge for diagnosing? Is that the charge for treating it. There’s separate charge for testing. That’s an understandable code description.

1

u/fuckmissbrixil 12h ago

there were separate charges for the lab tests and the antibiotics. Then there was a misc charge for the UTI itself.

1

u/TrustedLink42 21h ago

A few years ago, I went to the doctor for a routine maintenance visit. The nurse drew some blood and then I saw the doctor for 8 minutes. Here were my charges:

  • blood work $88.00
  • doctors fee $129.00
  • room fee $450.00

Who charges for a ROOM FEE?? When I called to ask them about it I was told that if I didn’t like it I should call my Congressman.

1

u/Jazzlike_Patience_44 15h ago

I hope you at least got a mint on your pillow

1

u/Old_Draft_5288 17h ago

That bill is about what you should expect anytime you show up at the emergency room

This is probably something you could’ve covered with urgent care

1

u/fuckmissbrixil 12h ago

So I wasn't in the ER for the UTI, I didn't even know I had one. Did you miss that part that's already stated?

1

u/statslady23 12m ago

The doctor was charging for the same services as the ER, as evidenced by the itemized bill in my case. The doctor charges went away after being forced to submit her bill to insurance. Plus, asking for itemization is a delay tactic. Wait them out. 

1

u/Particular-Kale2998 1d ago

Unless you're passing out from septic shock I would always recommend going to an urgent care first. If you're not in literal fear of dying an ER is going to be a long wait with a big bill.

1

u/fuckmissbrixil 1d ago

I wasn't in the ER for the UTI. I was in the ER for a life threatening emergency. I didn't even know I had a UTI until they did my lab tests

0

u/traumahawk88 1d ago

Shit, I go to urgent care for anything that doesn't require surgery. We have 2 UC centers near me that have full diagnostic suites including imaging (excluding MRI), one of them is 24/7. Sure it'll take me about 10 extra minutes to get there, but that's a fraction of what I'd wait at the emergency room (and if I'm not getting admitted, it's $50 rather than $200- if I need to get transferred TO hospital, then they can arrange that, and have done so too)

1

u/PoorAndSouless 1d ago

Lucky for having a 24 hour urgent care. My kid got an eye issue that swelled up after urgent care closed for today and I had to chose between ER visit (for what is probably a minor issue) or wait it out until morning

0

u/Big-Low-2811 1d ago

Why wouldn’t you get charged? Hospitals are expensive!