Tag Archives: billing

ProPublica wants to give you tips on hospital billing practices

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Health journalists across the country have been reading ProPublica’s accounts of the lengths to which hospitals pursue low-income patients for payment.

Earlier this year, ProPublica revealed that Methodist Le Bonheur Healthcare in Memphis, Tenn., had filed thousands of lawsuits against patients, including its own employees.

In the latest dispatch about medical debt, ProPublica reports that “thousands of people are jailed each year for failing to appear in court for unpaid bills,” citing a court in Coffeyville, Kan., “where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection.”

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Shedding light on upcoding in the ER

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Photo: Micheal J via Flickr

The Houston Chronicle’s Jenny Deam delved into emergency room billing – hospital facility fees as well as “upcoding,” which means categorizing relatively minor conditions as serious or even life-threatening ailments and charging a lot for them.

It raises costs to both the patient and the insurer. Continue reading

Vox provides access to ER billing database for reporters

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Photo: Micheal J via Flickr

Over the past year, Sarah Kliff (@sarahkliff) at Vox has been collecting emergency department bills from around the country and has reported a number of stories based on them.

Her stories included a patient who went to an in-network ER and was still billed nearly $8,000 and a major ER that – at the time – didn’t participate in the networks of any private health insurers, resulting in unexpected bills.

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Mississippi journalist’s reporting leads medical center to change billing practices

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

In April, Anna Wolfe, who covers health care for the Mississippi Clarion Ledger, started reporting on what appeared to be staggeringly high bills for using the emergency room at the Batson Children’s Hospital, in Jackson. The hospital is part of the University of Mississippi Medical Center, the only academic medical center in the state.

Parents who brought their children to the ER were being charged thousands of dollars in unreasonable emergency room facility fees that do not match the level of care received, Wolfe reports. Since that article was published April 15, Wolfe has continued to cover the complex ways the hospital calculates its charges. In the bills Wolfe reviewed, the hospital adds facility fees for ER visits, fees that are based on the level of care administered. Continue reading

Looking below the surface of those ‘outrageous hospital bill’ stories

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: RikkisRefuge Other via Flickr

Photo: RikkisRefuge Other via Flickr

We may need a new hashtag to supplement #surprisemedbills. Perhaps #shockingmedbills would fit because some bills are just that.

Recent coverage about a new mom in Utah who was charged $39.35 just to hold her newborn is a good example. Continue reading

Patients paying for confusion over prevention vs. treatment under ACA

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Under the Affordable Care Act, certain high-value preventive services – such as colonoscopies – are supposed to be free. No co-pay for the patient.

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But some patients are getting charged when they don’t expect it and perhaps shouldn’t be.

And there is a lot of inconsistency on who gets charged, depending on individual circumstances, what state they live in and what health plan they have. Part of it is confusion about what constitutes “screening” and what constitutes treatment. Plus doctors vary in how they “code” and bill for these services.

The variance is not just based on the individuals’ health circumstances (i.e. whether they had a polyp or not), but what state they live in, what health plan they have. The whole thing is generating confusion and complaints – and it’s a good story.

The thinking behind making preventive care free – specific preventive services, graded A or B by the U.S.  Preventive Services Task Force (USPSTF) – is that it makes it more accessible. It’s easy to put off – and put off and put off – screening. Research has shown that having to pay for it is an additional barrier.

The Kaiser Family Foundation, the American Cancer Society and the National Colorectal Cancer Roundtable just put out a report examining the problem. Three scenarios seem common: Continue reading