Why Medical Bills Are So High and How You Can Fight Them

HEALTHCARE EXPENDITURE PER COUNTRY $10,000 Presented by: COMMON MEDICAL BILLING OVERCHARGES $9,000 % of GDP $8,000 ITEM BILLED FOR Medical Recovery Services (ACTUAL ITEM) $$$ Charged 17.7% $7,000 $6,000 $5,000 SCISSORS (A PAIR OF SCISSORS) 9.3% 11.0% $9,600.00 $4,000 11.9% 11.2% 10.9% 11.3% 11.6% $3,000 VENIPUNCTURE 9.5% ah (INJECT NEEDLE TO DRAW BLOOD) $680.00 www.MedicalRecoveryServices.org 10.3% 9.4% $2,000 8.9% $1,000 The U.S. far outpaces any other country in healthcare spending for the industrialized countries. These billing overcharges are just some of the most common, but there are many more than these that are frequently overcharged. MALLOX (ORAL MEDICINE) $11.53/TSPN France Germany Netherlands U.K. CARDIAC CATHETER hh CATHETER) n Canada U.S.A Denmark Norway Sweden $17,600.00 PUBLIC EXPENDITURE ON HEALTHCARE PER CAPITA ATROVENT INHALER (INHALER) $580.00 th AUSTRALIA CANAOR VENTILATOR (USE OF MACHINE) DENMARK $2,109.00 FRANCE SERMANY It's not all private spending. U.S. taxpayers foot much of the bill, even though most don't get subsidized healthcare. NETHERLANDS FACTORS ACCOUNTING FOR GROWING WHY YOUR MEDICAL BILLS HIGH NEW ZERLAND HEALTHCARE COSTS NORWAY 3.2% SWECEN .8% SWITZERLAND -7.5% UNITED KINGOOM ARE SO HIGH Healthcare costs continue to stay extremely inflated due to the several factors listed .8% 1.3% UNITED STATES 3.2% to the right AND HOW YOU Š1000 $2.00 $3000 $4.000 $5,00 2000-06 -5% 2.5% CAN FIGHT THEM .8% HEALTHCARE SPENDING VS. THE ECONOMY .1% 2007-09 -3.8% 2.8% Population Health care spending has grown much faster than the rest of the economy in recent decades. Percent Increase 900% For Businesses and Consumers Use and Intensity (National health expenditures) 800% National Healthcare Costs (Gross domestic product) 818% 700% (Wages) Medical Prices 2010 600% DOCTORS CONSULTATIONS PER CAPITA (2011) 500% Australia UK 400%- 300% Canada Germany USA Mexico 200% 168% 100% 2.7 16% 1960 1965 1970 1975 1980 1985 1990 2000 1995 2005 2010 Fraud, errors, and abuse come in different shapes and sizes. The graphic below contains a visual representation for how these errors escalate. 4.1 5.0 THE FULL SPECTRUM OF FRAUD, ERRORS, AND ABUSE Despite the high spending, Americans don't go to the doctor very frequently. Optimal utilization Medically unnecessary 6.7 Fraud 7.4 9.7 Underutilization Overutilization Abusive billing practices Under Charged Normal Pricing Over Charged 13.1 HEALTHCARE COST DRIVERS Fee-For-Service Fragmentation in Care Delivery Administrative Advances in Medical Technology Reimbursement Burden In 2008, Fee For Service (FFS) plans comprised 78 percent of all employer-sponsored insurance plans in the United States. Doctors perform a high amount of tests or services in order to increase amount of Lack of care coordination often leads Administrative costs in the U.S. are to overtreatment, costing the United States between $158 and $226 billion annually, experts estimate. In a 2008 survey, 32 percent of adults reported experiencing duplicative or unnecessary care. A more recent survey of primary care physicians found that 42 percent believed patients in their own practice were receiving too much care. Advances in medical technology are a major contributor to improving health and increasing longevity, but unnecessary utilization of new technology - especially where a less costly treatment would be equally effective - drives health care estimated to be somewhere between $156 and $183 billion annu- and growing. Congressional Budget Office (CBO) analysis indicates that, over the next 25 years (under their Alternative Fiscal Scenario), population aging will be responsible for 52 percent of the growth in spending on major federal health programs. ally billable fees, whether necessary or not. spending. 5 TIPS TO LOWER YOUR MEDICAL BILLS 1. REQUEST AN ITEMIZED BILL It is your legal right to have access to an itemized bill. Request one from your provider in order to examine each charge. 3. CHECK PRICES AHEAD OF TIME 1 Before you enter a hospital, it helps to check into what a hospital charges for a procedure. This can be a good way to safeguard yourself against unfair pricing later on. 4. PRE PAY IN CASH The old adage "cash is king" applies in a big way to medical bills. This is your chance to determine a preset price for services that you know will be rendered. 2. REQUEST AN EOB An Explanation of Benefits (EOB) will give you a better understanding of what exactly your insurance company is responsible for, as well as what you should be paying. This is a good opportunity to identify if you have received an unfair claim denial. 5. GET A MEDICAL BILL AUDIT 5 Nothing quite replaces the help of a professional medical bill auditing service. These professionals know exactly how to interpret the crypitic medical bill coding and fight to get your bill lowered. 2 HAVE QUESTIONS ABOUT YOUR MEDICAL BILLS? Call us at (855) 203-7058 or visit www.MedicalRecoveryServices.org SOURCES: 1. https://www.optuminsight.com/~/media/Ingenix/Resources/White%20Papers/Key_Detecting_Fraud_wp_12_2012.pdf 2. http://www.huffingtonpost.com/2013/10/03/health-care-costs-_n_3998425.html 3. http://bipartisanpolicy.org/sites/default/files/BPC%20Health%20Care%20Cost%20Drivers%20Brief%20Sept%202012.pdf (PER CAPITA SPENDING) Australia New Zealand Switzerland 3,00 9E Japan