Hospital Billing Problems Part I
In case it has been awhile lets do a fast review: charges on your bill mostly come from an order given by a physician for your treatment. If the charge is a supply item it may appear on your bill in a variety of ways. Some facilities use stickers affixed to a “charge card” others use a scanner. Or maybe another way is used, but somehow that item shows up on your bill.
It is no surprise in this day and age to read about hospital bills gone awry. Millions upon millions of dollars mistakenly included on a medical bill. That is what Part I will address, human error.
Everyone makes mistakes and that happens when entering orders as well. Perhaps the date is wrong or the test is not exactly what the physician ordered. In short, anything could and probably does happen.
I know I have been called by the lab and radiology and even dietary asking about an order in the computer. Just the other day I was called by lab and asked if I wanted the magnesium level drawn now even though one was done earlier in the morning. Since there was no order I said no.
Safety of the patient isn’t compromised purely waiting for an order. So the service is rendered first and then an order is put in, most times the department will remind you to do so. So a stat x-ray can be completed with the promise of an order later.
So is the order always placed in the computer? After the situation is more calm then we all try to catch up and put in missing pieces. But sometimes things are missed.
Other safe guards are in place also, for instance hospitals may require doctors to enter their own orders into the computer. This eliminates several steps and presumably would cut down errors. Nurses routinely do chart checks to make sure the orders are noted and correct.
And remember those stickers and supplies? I can give you a personal example, this happened a few nights ago. I had two sick patients and I was very busy running from room to room giving care. At the end of the shift I had sticker all over my uniform top from the supplies I had used.
When it was time to affix the stickers to the “charge cards” I had to remember which sticker and corresponding supply I used for which patient. I am sure I did just that, but with the acuity of patients nowadays and the hectic work load stickers can be misplaced.
Even well intentioned actions intended for comfort of the patients can lead to unforeseen consequences. As I have said I have worked in a variety of care setting. This example took place in the Neonatal ICU. There we routinely put small fleece squares in the bottom of the isolette to prevent skin breakdown.
How could we have guessed that that little square would be counter productive. You see in some cases the fleece made the x-ray appear more patchy and white than it was in actuality. The cause was found quickly for the patchy x-ray by a clever physician and was fixed immediately.
So I hope you can see how human error can contribute to hospital and medical bill errors. I have given several examples how they may occur. The next part will deal with a different kind of error however.
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Tags: Healthcare
