Ben s Battle Deciphering Medical Bills

Ben and Adrienne Ochs never thought much about their insurance coverage. They paid their premiums, never had any serious health problems, and assumed if they did they'd be covered. All that changed in 2004 when Ben was diagnosed with cancer and his insurance company refused to cover his treatment. "You put your faith in the system because you pay your bills," Adrienne says. "Then you get denied and everything comes toppling down."

The Ochs sued and eventually reached a settlement with the company, but not before they'd paid thousands of dollars to Iowa doctors and hospitals. That's when Adrienne picked up a book that advised having a professional look over your medical bills. The Ochs hired Jessie Maurer.

"Mistakes happen," says Maurer. "If it happens to my client, I'm going to get their adjustment." And for the Ochs, she did just that. They recouped about $20,000.

Maurer spent 30 years working in medical billing, insurance and management. Now she has her own business as a medical billing advocate.

"Through the years I realized the quandary people would be in with their medical bills," Maurer says. "Once they'd gotten through their illness or surgery, the real horror story began when they got insurance notices and medical bills."

Maurer has clients all over the country. One had been charged $12 for what a hospital called a mucus retention kit. Most of us would call it Kleenex. Another hospital charged a patient $1,000 for a toothbrush. It was a data entry error. An elderly man hired Jessie to make sense of his hospital bills after he'd had hip replacement surgery. She found a bill for umbilical cord testing, something only a new mother would see on a hospital bill. "It's indignation I feel!" Maurer says, "These people are being ripped off!"

Diane Sexton hired Maurer to look over her mother's paperwork when bills started arriving in the mail after a few hospital stays. "I couldn't even begin to sort through all of her stuff," says Diane. Jessie did the sorting for Diane's mother Evelyn, and found an unopened envelope. Inside, there was an identification card for a private insurance plan from Evelyn's former employer. Evelyn says she didn't sign up for the plan, but from the moment that new card showed up in the mail, her original Medicare coverage disappeared and bills started rolling in.

Evelyn says it was overwhelming, and scary. Now Jessie is working on Evelyn's behalf to straighten out the billing confusion. It's a slow and tedious process that few of us can begin to understand. "Find an advocate," says Diane. "Find someone who can help you through it because it's just crazy."

If you've been denied coverage by your insurance company or you're uninsured, ask providers for a discount. According to Johns Hopkins Center for Hospital Finance & Management, insurance companies negotiate up to sixty percent off. Work up the courage to contact your hospital or clinic CFO and ask for a price reduction.

Make sure to scrutinize your bills. If you don't look at the bills you receive, you'll never find the mistakes, like a $12 box of Kleenex.

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Ben s Battle Deciphering Medical Bills