I can’t understand what all these items are on my hospital bill. What’s “R&C Int & C Int 1 days @ $12,356?” Why does 1 Tylenol cost $2?

Answer:
Hospital bills can be very confusing—not to mention completely unrealistic, and they commonly have errors.

Hospitals use a “chargemaster” list of prices for each service they provide. As Steven Brill points out in his revolutionary 2013 TIME article “Bitter Pill: Why Medical Bills Are Killing Us”, these charges bear no connection to costs.

He mentions Tylenol being charged at $1.50 per pill when you can buy 100 generic acetaminophen (the ingredient in Tylenol) for $1.49. He cites the case of a cancer patient charged $13,702 for one shot of Rituximab, which the hospital bought for no more than $3,500. That's “a 400% markup on a single dose of a life-saving cancer drug,” he notes.

Without looking at your bill, it’s hard to tell what’s what; different hospitals use different terms, but the CPT (current procedural terminology) code is the same between hospitals. I'd guess “R&C Int & C Int” at a daily charge of $12,356 is for admission to an intensive care unit—not a cheap place to stay.

Medical RecordNot only are hospital bills often stratospheric, they frequently contain errors. Medical billing expert and advocate Edward Waxman of Edward R. Waxman & Associates says, “If you've ever spent time in a hospital, you've almost certainly been overcharged.”

Look at your hospital bill and look for mistakes. When you get it, compare the EOB (explanation of benefits) from your insurance company to the bill and make sure they match. Query the hospital if they don’t, or the insurance company if there’s anything they refuse to pay.

Consider trying to negotiate some of the unrealistic prices, especially if you are uninsured (many hospitals give an automatic discount if you are, but you often need the chutzpa to ask). Here's a good article that explains a lot of the vagaries of hospital billing. You can also get help with your hospital bill through the Patient Advocate Foundation.

1 Response

  1. Is there a way to find out before you get a treatment what it'll cost? And to compare hospitals before choosing one? Like, an online source to price-match?

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