NJ hospital disputes should put a spotlight on billing procedures

If you've ever had a medical procedure done, have you ever wondered why the total amount was so high? Yes, there are deductibles and co-pays, but have you ever thought to yourself if everything was calculated correctly?

It might be something you want to start doing, especially if your higher-than-expected bill is coming from the hospital. In certain situations, you should question the process.

Before we get into it, let's first point out that there was an announcement made recently regarding medical debt. Governor Murphy recently spoke about lowering medical debt for those struggling in New Jersey in his sixth State of the State address (read more about that here).

That announcement, however, didn't have too much context to it. As of now, it's not entirely clear if that just means they'll be working on a way to help lower medical debt or if it'll address problematic billing procedures.

And it's a shame too. It's a shame because most of these issues that come up aren't the fault of the medical care staff on-site. If you need to go to the hospital, they do whatever they need to to ensure you get the proper care you deserve.

The issues tend to occur on the billing side. The areas where all the codes are put in and itemized statements are sent to the insurance companies.

And sometimes issues pop up so late that you might not even remember what's what by the time you learn about the problem. You're just faced with a bill and are expected to pay it.

That's where the problem comes in. And not just me, but many others have dealt with this very issue.

I've been open about this to my on-air audience that I have an auto-immune issue I have to deal with. To keep it in check, I have to get a procedure done twice a month.

That part's not a big deal. The hospital staff is nice and always asking how I'm doing. And I'm sure it's probably similar for you if you need to go in somewhat regularly.

However, the hospital started having billing issues with not only me but with my doctor as well. Not only that, but my doctor's other patients were dealing with related problems when it came to how much the hospital said we owed.

For me, it's been an ongoing problem spanning over the past several years. And just recently, another problem reared its ugly head.

In January 2024, I received a call from a hospital debt collector. Nothing shocking since I've been dealing with this nonsense for a long time now.

This one was over a service date in June 2022. Think about that for a moment. I'm supposed to recall information from almost two years ago.

Now normally, I would be concerned. But since this was around the third issue now, I wasn't surprised.

The biggest problem I had once was when they ran the insurance incorrectly. On that one, they said I owed around $10,000. But after about six months of battling them, they admitted that the insurance was never run properly.

At the end of the day, my out-of-pocket was just under $100. Certainly a heck of a lot lower than $10,000, and certainly nowhere near what my responsibility ultimately was.

Then the following year, another issue occurred with the hospital debt collectors saying I now owed around $5000. But once again, after several months of battles and different stories, it turned out it was an administrative error.

Essentially, someone changed one service date from being settled to moving some of those dollars to satisfy another service date. In other words, one service date that was at $0 owed was now suddenly a bill for $5000.

I don't even know how you do that. How do you shift dollars from one service date to the next and not tell the patient? That one was also a mess that needed to be fixed.

Which brings us to today. The call I got on January 2024 not only said I owed around $4500, but it also said three different insurances were used.

Right off the bat, I knew this was an error because I don't have three insurance companies. One of the insurances they mentioned was my wife's from her job, which made absolutely no sense since I'm not even on her insurance.

That one again is for a service date of June 2022. And as you might've guessed, this one is being disputed. The story of my life with this New Jersey hospital.

And as I mentioned earlier, it's not just me. In fact, it got so bad with all of my doctor's patients that none of us are using this hospital anymore.

The new facility I now go to hasn't had a single hiccup when it came to the bill. Not only that, but they also settle it quickly.

A stark contrast from what I've grown so accustomed to having to deal with when it comes to medical bills. And that's why I'm telling you not to believe the numbers you see.

If the numbers seem wrong, don't accept it, and don't pay right away just to clear it. As in my example earlier, I would've given the hospital thousands of dollars more than what they were owed as part of my responsibility.

And honestly? It oftentimes feels like they hope you forget and just give them whatever they say you owe. Don't be afraid to question everything.

If it seems wrong, it just might be. Dispute it until you know for sure the amount you're being asked to pay is, in fact, the amount that's your responsibility.

The above post reflects the thoughts and observations of New Jersey 101.5 Sunday morning host Mike Brant. Any opinions expressed are his own.