Many patients find medical bills hard enough to understand. Now a practice called split billing is becoming increasingly common. This can make medical bills even more complicated, and worse, lead to higher charges that the patient doesn’t learn about until he or she receives the final bill.
Split billing most frequently occurs during a checkup or annual physical. If a physician notices a problem during the checkup and treats it, the patient can be billed separately for both the physical and the treatment. It can also occur in cases where the patient has chronic conditions such as diabetes or heart disease, and the physician discusses and/or treats them during the course of the physical. The medical biller can see that as two separate services and bill for both. Finally, it can also happen when the patient is seen by multiple doctors and/or nurses, each of which is billed separately.
Another form of split billing occurs at a hospital, where a patient can be charged a “facility fee” for the use of the hospital’s equipment and resources as well as for the doctor’s time. Some hospitals charge this fee if the doctor’s office is on the hospital campus, even if the patient never enters the hospital building itself. Some state governments and the federal Medicare bureaucracy have been moving to outlaw facility fees, saying that they are an unnecessary extra burden for patients.
While patients who have received unwanted bills because of this practice may be angry at their doctors, the doctors put the blame on insurance companies. The doctors say that insurance companies are becoming more specific in their billing requirements and demand documentation of every service provided during an office visit, leading to split bills.
The best way for patients to avoid being split-billed is to talk to their physicians. If they do something that’s not part of the usual physical, patients should ask if it is going to be billed separately. Asking questions can often help avoid extra costs. Some medical practices let patients specify ahead of time that they want only the physical examination and nothing else. It may also be a good idea to schedule multiple visits to deal with multiple medical problems instead of trying to take care of everything all at once.