Understanding Your Hospital Bill

We have all experienced that maddening moment of looking over a bill or financial document and just not being able to comprehend how the numbers add up. To alleviate confusion for those of you not familiar with medical billing – which is most of us – the following information will assist you in understanding some hospital billing procedures and might explain why you may have received a hospital bill.

In general, every time you as a patient receive care at a medical center or hospital, a new account is opened that corresponds with the date you received care. Upon discharge from the hospital, you are sent a hospital bill for the services provided. In most cases a summary description of services provided for that account is sent soon after your discharge. Anesthesiologist, radiologist, pathologist, and other physicians involved in your care will bill you separately for their services.

Typically, there are three different types of hospital bills that you might receive:

  • Itemized Bill - details the services provided, including dates and charges for specific services. You are entitled to an itemized bill and will be provided one upon request.
  • Summary Bill - includes the total charges for the hospital visit. This is what is submitted to the insurer. These bills are typically consolidated per service category, for instance: operating room, laboratory services, and room and board.
  • Billing Statement - shows the dates of service, total billed, status of the account, the amount paid by the insurer, and what is due from the patient.

In addition to your hospital bill, you may also receive other bills from physicians, including emergency physicians, surgeons, anesthesiologists, pathologists or other specialists who might have participated in the care you were provided.

The amount you personally owe for the hospital care or procedure is typically referred to as patient responsibility. If you are insured, these out-of-pocket costs are identified in your health insurance coverage policy and are often referred to as co-pays or deductibles.

From your health insurance carrier you might receive an Explanation of Benefits (EOB) statement. An EOB is a statement identifying the amount you owe for your hospital care and the amount that was covered and paid for by your insurance.

It is a good idea that you become familiar with the terms and conditions of your health insurance coverage. Knowing what care your health insurance covers can help alleviate confusion and unnecessary billing. If you have questions about how your insurance company processed your claim, it is best to contact your carrier directly to get a clear understanding of your benefits and your insurance coverage.

If you are not insured and are interested in information about charity care or financial assistance programs, contact your local hospital to inquire about programs they may offer.

If you have questions about your hospital bill, need assistance with the billing process or help with planning payments for your healthcare expenses, you should contact the billing or accounting department at the hospital where you received treatment.

Hopefully this information has helped provide you with a better understanding of hospital bills. So you can now focus your energy and attention on your health and wellness and not on trying to figure out the difference between a billing statement and an EOB.