What to Do when You Get Another Person's Medical Bill

Medical billing errors are not that uncommon and has happened to most of us. Sometimes we are charged for a prescription that we weren't given, or billed for an IV kit that was never used or meals we never ate and so on. Most of these overcharges are pretty minor, except when they aren't, such as the time I was billed for another woman's surgery.

In a peculiar twist of fate, I delivered my eldest child the same day another woman with the same name as mine was in the hospital delivering her baby. She had a cesarean section, whereas I went with the no-frills natural childbirth plan which had me out of the hospital in about 6 hours.

Of course, none of us knew about the other until I received her bill for about $24,000. Fixing the problem wasn't that hard, but did mean moving quickly and making the following calls.

Step 1: Whenever there is a billing mistake, the first step is to contact the hospital billing office directly to let them know about any error. In my case, I called the billing department immediately about the billing error.

Step 2: Next was a call to my insurance company. By calling immediately, the claims process was stopped before any funds were issued. In most cases, hospital visits and procedures are "pre-authorized" so the insurance company knows what to expect. Had I been billed for an gall bladder removal, the insurance company would have caught the mistake since would no have matched up with the pre-authorization diagnosis. The fact that that the hospital stay was for an emergency cesarean was a scenario that could have slipped through the claims department.

The claims processor on the phone noted that she would contact both the hospital and my physician to straighten out the mess.

Step 3: My obstetrician's nurse was the third person on the list where I explained what had happened and that the insurance company would be contacting the office for clarification. She pulled my file and had the information ready to fax to the insurance office when they called.

With everyone now on alert, it was just a matter of waiting for the insurance company and the billing office to get the information straightened out. From start to finish, correcting the billing error took about three weeks. The next time I heard from the hospital was when I was mailed the corrected bill with the insurance copay already taken out.

When it comes to fixing a medical billing error, the secret is to move quickly instead of waiting for the problem to fix itself. In my case, quick action made it possible for the hospital billing department to backtrack their steps and fix the error before the mistake compounded into a tangled mess.

More by this author:
6 easy ways to cut your family's medical costs.
How to negotiate a payment schedule with a hospital.