Why do I have so many unexplained charges on my itemized bill?
By Kathy H. Wood, Ph.D., FHFMA
If you have ever been to a hospital and received an itemized bill, you’ve probably questioned many of the charges. For one, why does a simple pain reliever cost so much? Why are there physicians on my bill that I never even saw? Why does it cost so much to stay in the hospital? Why did I get charged so much for anesthesia? The questions go on and on. So, why does it cost so much and why do we see these arbitrary charges?
First, think about a hospital as a hotel with full services. It has to operate 24x7, 365 days a year. Unfortunately, most of us can’t plan when we get sick and when we need full services. This means the hospital has to have staff, rooms, equipment, electricity, pharmaceuticals, and others available to provide service for you when you need it. Hospitals have an extremely high standard of cleanliness and sterility, requiring excellent staff and many cleaners. Food must be available for patients as well as the staff, visitors, and family of the patients. Waiting rooms need to be available and staffed to assist the visitors and provide a level of comfort. Parking must be adequate to accommodate the many visitors. The climate must be controlled throughout the day and evening. Many accidents occur late in the evening or early mornings, which mean physicians and other staff need to be called to come in for emergency surgery or services. This requires quite a commitment from the medical staff to be willing to be on call and they need to be paid a higher rate similar to shift differentials. Other costs that many people are unaware of are the liability insurance costs. Medical personnel, particularly those who have a risk of injuring patients during the procedure or being put to sleep, have to pay excessive fees to cover their liability.
Additional costs that go into your care include: Medicines for all treatments need to be available immediately in many cases. This requires inventory and staff to pull and administer the meds. Results of tests need to be interpreted by specialist. Physicians may be the ones ordering the tests and such, but the results are read and interpreted by other medical specialists such as radiologists, oncologists, etc. The specialist who interpreted will be shown on your bill, which would explain why you do not recognize the name. Equipment used for cat scans, MRIs, and other procedures requiring specialty equipment can be very expensive. The equipment is costly and it usually requires a specialist to operate the equipment, in addition to interpreting the results.
Do these unexplained charges seem to make more sense now? Discuss your thoughts with me on Twitter @CTUHealth, or leave a comment below.
Dr. Kathy Wood, Ph.D., FHFMA is the University Dean of Health Sciences at Colorado Technical University. Explore Kathy's background or connect with her on Twitter @CTUHealth.
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