Put your hospital bills under a microscope

In times like these, the last thing you need is a hospital bill that can wreck an already fragile budget. This is often the fate of elderly patients who incorrectly assume that Medicare will cover everything.

Not so, as my aunt discovered early last year after a two-night, 2 ½-day -day stay at a for-profit hospital in Florida. There is a lesson: No matter who is footing the bill, hospital charges should be carefully vetted by someone who, with the Internet and perhaps professional help, can decipher the codes and uncover unreasonable and erroneous charges.

My aunt, then 88, had fainted in her apartment and was taken to the hospital by ambulance. After an evaluation in the emergency room, she was admitted to the hospital for what turned out to be a side effect from a new medication.

Five months later, she received a bill stating that of total costs of $18,865 (which included $5,874 for a justifiable CT scan of her head and brain), she still owed $992.60 after Medicare and secondary insurance. The sum seemed prohibitive to my aunt, who lives on Social Security and a small pension.

$457 for eyedrops?

But that is not what prompted her daughter to question the bill and carefully review the itemized charges.

"What leaped out at me was a charge of $456.67 for the eyedrops she uses once a day," my cousin told me. "My mother pays $85 for her prescription, which lasts about 40 days, and she had her own drops with her."

Further perusal revealed that each baby aspirin, each multivitamin, each 500-milligram tablet of vitamin C and each dose of stool softener was billed at $4.07, for a total of $40.70. She was also billed for six doses of a heart medication ($10.81 each), only two of which should have been administered.

When my cousin called the hospital to question the charges and explain her mother's limited finances the hospital suggested an audit but warned that such investigations often leave the patient with a larger bill. My cousin refused to be intimidated and requested the audit, which resulted in the removal of nine erroneous medication charges and a bill reduced to $500.

And when she replied that this was still more than her mother could afford, the hospital lowered the bill to $200 - as long as she paid it that day.