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For this article we look at another problem. And unlike the first problem this may be built into the system. One could argue it was intentionally built into the system.

I may be cynical and the problem maybe happenstance, but nonetheless it gives me great cause for concern. You see all the caregivers you encounter in your hospital stay want to provide quality care. Be they techs, nurses, dietitians or phlebotomists, we all have the same goal. But I am not so sure that is the case for the billing department.

I have seen and audited a great many hospital and medical bills. So even though that last statement about billing seems bold I am still dumbfounded with the blatant excesses I see on the bills.

Later I will share some sample bills. I will show you confusing and difficult to read most of them are. Especially for someone with no prior experience with billing, these bills can be a nightmare.

Here is a quote that aired on the CBS News 60 Minutes program. It comes from Carmela Coyle of the American Hospital Association. “Actually, what hospitals charge for a service is the same for everybody, whether they have insurance or not. What’s confusing for everybody is that what a person ends up paying in this country can be very different.”

So to put it another way, a portable chest x-ray costs the same for everybody in the country. But we might pay different amounts?

Difficult to understand isn’t it. And more difficult to be involved as with a hospital bill. That is what I mean by being inherent in the system.

Each hospital has a master list called the “charge master”. In it all the services and supplies in the hospital are priced. Then when a patient is billed some are given discounts while others pay the full Charge Master price.

When was the last time you were able to compare prices for hospital costs? Can you call ahead for a realistic cost for an appendectomy? It would be very difficult to do so. That is why Dr. Gerald Anderson of Johns Hopkins Bloomberg School of Public Health says hospitals have no reason to control prices. Hopefully that will change in the future.

Dr. Anderson knows about such things, after all he helped draft the rules Medicare uses for reimbursements for hospitals. And why can this happen, according to Dr. Anderson, “… essentially, they can get away with it.”

I know it is confusing and I know it may not affect you right now. But trust me, one day soon you will be faced with a daunting hospital bill which includes overcharges and errors. It happened to Richard Clarke. And because it did he began the Patient Friendly Billing project.

Next time we will look at how Richard Clarke has helped all of us with confusing hospital bills.