The Whys of Hospital Bills

If you are unfortunate enough to go the the emergency room or even worse being a direct admit to the hospital not much happens at first. In fact no charges occur until you are seen by a physician or a nurse practitioner or a physician's assistant. The treatment starts the same time as the charges.

And all the items on your hospital bill from that treatment the physician orders. If you get an IV it was because of a doctor's order. If you get an x-ray same thing. Medications, dressings, equipment what have you all come from a doctors order.

This is simplistic and once we get into the hospital bill I will contradict myself. But for now, this is a good place to start. Once we delve deeper into hospital billing I will give examples of what Medicare will allow and what Medicare will not allow. But as I said that is for much later.

Like I said that is for the future, as for now the doctor's order is entered into the computer. The computer order will have all necessary components. For instance if it is a lab draw the order will have information on the test and who will draw the sample.

Likewise, if an x-ray was ordered it is entered into the computer. On the computer screen it will specify if it is to be a portable x-ray or not, and what body part is to be x-rayed.

From personal experience I can tell you that personnel from both radiology and lab will ask "is the order in the computer"? And rightly so, the radiology technician and all the lab personnel involved want to be paid. The order that was generated by the computer entry will be billed to the patient to pay for the service performed.

If you have looked at a hospital bill lately you will not see any charges for nursing services. That is because nursing care is included in the cost of the room, the ED room or the ICU room or the cath lab room.

So any service provided by the hospital for your care should be entered into the computer. It doesn't matter if that service is an x-ray or to order a meal or physical therapy or even a breathing treatment, it will be in the computer. Even a consult for another physician for a surgeon or a gastroenterologist is entered into the computer.

However, for supplies charges are done differently. I have seen a couple of systems and i am sure there are more. It could be a sticker from the time is placed on a patient's charge card. Or I have also used a hand held scanner that is used to scan the bar code of an item used.

In that way the patient is billed for the item used. Now again this is simplistic and later on I will contradict myself when we discuss routine versus ancillary services. But for the most basic approach that is how the patient is billed.

From what I have explained it seems like a simple system. But as we continue our look at hospital billing errors and overcharges this simple system becomes incredibly complex.

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