Without AMPS Your Client Would Have Paid for This Billing Error

Imagine if you got your credit card bill in the mail and it said

“You owe $5,000” with no explanation.

You would be on the phone, demanding to see an itemized bill, right?

When it comes to hospital bills, you don’t get the itemized version of the bill, so you often have no idea what you are actually paying for. You have no clue if the services you’re paying for were actually provided, or if the materials you’re paying for were actually used.

Let’s say a patient is going into surgery to put a screw into their finger that they broke playing baseball.

A nurse who is assisting the surgeon would go into their supply closet and grab a box containing five screws. As soon as that happens, the patient is charged for that whole box of screws, when the surgeon will likely only use one of them.

Keep in mind, this is not an ordinary screw you would buy at Home Depot for 30 cents.

This is a screw that costs $3,000 to $5,000.  

Typically, a hospital won’t take the time to counteract that charge on a patient’s bill. As the payer, you receive a Uniform Bill from the hospital as an invoice. Since this bill is not itemized, you have no way of knowing that the hospital charged for five screws and only used one.

This is where AMPS Medical Bill Review service comes in. Our board of certified physicians would know to look at a charge for five screws on a surgery on someone’s pinky finger and know right away that the surgeon didn’t use five screws.

AMPS does that extra investigation, finding billing errors

that only Board Certified Physicians know to look for.

A hospital sends out a bill to an employer for MRI charges for a patient. As an employer looking at the Uniform Bill, there is no way of knowing that the bill is actually for two MRI’s—one on Monday and the other on Tuesday.

When our medical professionals review this hospital bill, they would see these two MRI charges and know that this is an error. There is no value whatsoever to having an MRI performed on two consecutive days.

What likely happened is whenever the patient was set to go into the first MRI ordered, the nurse recognized that the patient was nauseous. Any nurse would know that a nauseous individual couldn’t be put into a MRI machine, so they would put it off until the next day.

In the hospital environment, as soon as a service is ordered, it’s put on a patient’s bill.

When the first MRI was ordered, it was immediately added to the patient’s bill, and never taken off. When the nurse set up the second MRI, that patient got billed twice.

An average MRI costs $5,500 gross billed charges.

If that’s not caught by a service like AMPS Medical Bill Review, that employer is going to be overcharged by $5,500.

AMPS does that investigation to make sure that the payer is not paying for, and the hospital is not charging for, services that aren’t legitimate.

Explore how AMPS Medical Bill Review can help you save significantly on your hospital bills.

This is Part 2 of AMPS educational series on Medical Bill Review. Click here to read Part 1.