Huge Medical Bills You Shouldn't Pay
For families squeezed by falling incomes and rising prices, the last straw can be an unexpected medical bill. Even those with health insurance can see huge bills for the uncovered portion of their care. But a CBS News/Business Week investigation found that many of these so-called "balance bills" are seriously out of balance - and shouldn't be paid.
Several months after back surgery, Linda Burdick sat holding a hospital bill for almost $60,000.
And this was after her insurance had paid its share of the bill. She had no idea she'd be billed for anything close to that amount.
"And just said to my husband, 'Oh my God, we're going to owe $60,000 to the hospital. How are we ever going to pay that?'"
The bill Burdick received is called a "balance bill." When the insurance company doesn't pay the total charge, doctors and hospitals often bill patients for the balance. The problem is, millions of balance bills these days are either illegal - or they are highly inflated.
Last year in California alone, the insurance industry reported that 1.7 million patients had been "balance billed" $528 million above what the patients owed.
Burdick hired two billing investigators. After demanding an itemized accounting, health care navigators Lin Osborn and Beth Morgan believe Burdick was overcharged by $40,000, for items like six surgical screws - at $1,750 each. They say overbilling is now the norm.
"Outright wrong is 100 percent," Osborn said. "I've never seen a hospital bill that I thought followed all the regulations correctly. Not once."
Burdick's hospital, the Beth Israel Deaconess Medical Center in Boston, declined an on-camera interview, but said in a statement that her bill was set by her insurance and "is not determined by the hospital." Hospital officials said they have "no evidence of overcharges in her bill, but would be willing to correct any mistakes."
Read BusinessWeek's investigation.
Burdick also asked her state attorney general, Richard Blumenthal, for help. Blumenthal's office has handled thousands of balance bill complaints.
"There's no explanation for some of them except purposeful balance billing or overcharging," Blumenthal said.
"If you don't fight, you are going to lose," Burdick said.
Burdick's fight applies to anyone with a suspect medical bill. All patients have the right to an itemized bill. Any charge can be disputed directly with the hospital.
Patients can complain to their state attorney general and, as Linda did, contact a medical billing advocate. Burdick says she's still working with Beth Israel Hospital hoping to bring that $60,000 bill into better balance.
If you think you're a victim of medical-bill fraud, or "balance billing," and are seeking help, check out our list of resources.
