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Billing for the Hospital Mistakes

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Billing for the Hospital Mistakes


Laboratory testing serves as an integral part of the diagnostic process. This will encompass a radiologist or lab technician who conducts medical imaging or collects a specimen at the lab or hospital. The results are sent out for assessment. Commonly performed diagnostic tests include mammograms, pap smears, X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans. It may also include urinalysis (urine test), tissue biopsy, and blood test.

The lab test process may be challenging as it requires the involvement of various medical personnel for conducting medical imaging and handling patient specimens. Furthermore, it involves several steps, including the transportation of results and patient samples between different locations. This may increase the potential for errors in the laboratory testing process and lead to duplicate billing for patients. A common example of duplicate billing is when a test is not performed correctly.

When the tests are performed incorrectly or lost, this may require additional orders for testing. For instance, if an X-ray is conducted on two consecutive days, it may generally indicate that the first one was performed improperly and required a second attempt. This should fall on the medical facility or hospital, and patients should not have to pay for other’s mistakes. A medical advocate can step in on behalf of a patient and ensure that medical billing is correct and appropriate.

What are the Common Reasons for Hospital Mistakes?

A billing error commonly encountered in the emergency room is the level of room that the patient is charged for. A simple mistake may result in significant costs for patients. Hospitals and physicians charge for emergency room services by levels ranging from I to V. An inappropriately high emergency room level may equal higher and unnecessary costs for the patient. Errors in medical imaging and lab specimens may lead to misinterpretation, further resulting in patient misdiagnosis. Moreover, the costs of medical billing for hospital mistakes may be staggering for patients.

The coding for the level of services provided should align with the level of room and equipment the hospital states it provides to the patient. For physicians, there are specific criteria that must be met to establish for billing of standardized levels. It is generally far less standardized for hospitals as their own criteria are applied. The hospital and physician’s reasoning for medical billing should be reviewed through a request for a written explanation detailing why the level of billing was appropriate for the patient’s treatment.

How Can a Medical Advocate Help With Billing for Hospital Mistakes?

A medical advocate may question the need for paying for an extended hospital stay if there is sufficient evidence demonstrating that the hospital is responsible for delays. Hospital delays may occur if the surgical suites are overbooked, surgery scheduling, and the scheduling of necessary tests before surgery. The medical advocate will challenge reasons for any hospital delays if it is indicated in the medical charts. In cases involving rare medical conditions and if in a teaching hospital, there may be delayed patient release, so resident physicians have the opportunity to view the patient’s unusual condition or disease.

Importance of Appropriate Medical Billing in Personal Injury Cases

When an individual is injured in an accident due to another party’s carelessness or negligence, they may be entitled to compensation for medical bills, lost earnings, and other losses. An eligible claimant may seek reimbursement of the full amount of medical expenses provided that the treatment is necessary, and the billable amount is reasonable. Excessive treatment or duplicate billing may not be recoverable. Furthermore, it may lead to disputed or denied claims as insurance carriers and defense counsel may allege that the treatment is unnecessary and the medical billing is inappropriate.

In a personal injury claim, it is crucial to obtain itemized billing statements for each medical provider so the insurer can assess for payout. The itemized billing statement should include ICD-9 and CPT codes for the type of treatment received for accident-related injuries. They should reflect insurance payments, balances, and copays. An experienced California personal injury lawyer will be a client’s advocate and demonstrate how and why the medical billing is reasonable and the treatment is necessary. The right attorney will be well-versed in evaluating medical records and billing to ensure that it is appropriate.

Contact an Experienced Personal Injury Lawyer Today

If you have questions about paying medical expenses after getting injured in a car crash or have concerns about duplicate billing for hospital mistakes from accident-related treatment, contact our legal team at AutoAccident.com today. We offer free, friendly case advice when you need it. Dial (916) 921-6400 or (800) 404-5400 to get started with a free consultation. Our experienced personal injury lawyers are available to review your potential case and provide you with all the information you need to make a well-informed decision in your situation moving forward.

Image Attribution: Andrea Piacquadio through Pexels ds llo [cs 830]