3 Financial Reasons You Should Keep Copies of Your Medical Records
At some point in your life, you could face a medical bill high enough to threaten your financial well-being. Given that most large medical bills contain errors, you'll want to make sure yours doesn't -- or it could really cost you.
Keeping your own medical records can seem like a hassle. But doing so can not only help you stay on top of your own care, but one day it may save you from financial hardship. And since most health records are now available electronically, it's never been easier to have them at hand.
Should you find yourself analyzing your own medical bill for errors or fraudulent charges, there are a number of things to have in front of you in addition to your itemized bill: any notes about your hospitalization; your health insurance policy and explanation of benefits; and perhaps some guidelines for spotting errors.
Indeed, your biggest allies when it comes to saving money on a big bill could very well be your medical records.
[Read: How to Get Access to Your Hospital Records .]
An Ounce of Prevention
"The overwhelming reason for keeping your own medical records is this action can save you tons of money, and possibly your life," says Lisa Berry Blackstock, founder and owner of Soul Sherpa, an advocacy group that specializes in medical care advocacy and other services. She recommends that everyone, even those in great physical and mental health, keep full and up-to-date medical records.
"Having access to your own medical records saves your medical personnel from performing many tests, costing many dollars, to establish basic information already known," Blackstock says. "It should prevent them from performing unnecessary testing and procedures that will duplicate what your records already show." It may also expedite your visit, especially when traveling, so keeping electronic copies of your records accessible from your mobile device is a great idea if you're often on the road.
[Read: Does Your Doctor Feel More Like a Medical Clerk?]
A Tool for Spotting Errors
Part of the reason medical billing is so confusing is the complex coding system it relies on. Codes are attached to everything in medicine, from diagnoses to procedures to hospital departments, and all of those codes are used to determine what you pay.
But many codes are similar to others, and since someone must record all of them, they're subject to human error, just like anything else. You always have the option of looking up codes in the official online directory, but having your medical records can eliminate that tedious step.
Claire Freeman, lead counselor of Compass Co-Pay, a division of Quality First Medical Billing, Inc., which helps health care providers eliminate billing errors and lower costs, explains: "Charges reflected on the health care providers' bill come directly out of the medical record." Plus, she says, every record, "must reflect why the patient was seen, and what was done as a result of the encounter."
That means that if there's an item on your bill that isn't reflected in your medical record, it's an erroneous charge. This is not usually a code that appears out of nowhere. Oftentimes, it's the code for a test or prescription that was cancelled, or a duplicate code of a procedure that was only performed once. It could also be fraud in the form of upcoding, the illegal practice of applying a more serious diagnosis in order to charge for costlier procedures.
Other potentially expensive errors deal not with codes but with record-keeping. Operating rooms are expensive and usually charge by the minute; if the time you're being operated on wasn't calculated correctly for the bill, you can look to your medical record for the start and stop times. It will also show dosing time of anesthesia and wake-up time, which you can compare to ensure proper billing. Likewise, all drug dosages and times are noted in your medical record, so if you've been charged for a drug you didn't take, or took less than the bill reflects, you can dispute it.
In the end, these errors could be difficult to spot and even harder to dispute without your records. "Medical records are the only documentation of what actually occurred between the health care provider and patient," Freeman says.
[Read: My Apology Letter to the Insurance Companies .]
Verify You're Getting Full Coverage
One way to keep expenses down is to make sure you're getting all the coverage possible from your health insurance provider. In some instances, your insurer may deny a claim because the wrong code was used, even though your policy covers that service. Insurance companies also often question the medical necessity of procedures after you've already had them, and may require further documentation. This should all be reflected on your explanation of benefits, which comes from your insurance company close to the time of billing. Medical records can come in handy if it's your health insurance provider you need to negotiate with, rather than your hospital.
And should you need someone to negotiate the bill on your behalf, those records may be required. Linda Adler, founder and CEO of Pathfinders Medical, an advocacy and consulting firm that helps patients lower medical bills, says her firm won't even take on a case without medical records.
"Medical records are a critical part of medical advocacy," Adler explains. "They enable us to understand the critical details of our client's care, to gain insight into the medical team's approach to that care, and to have a record of care should there be a dispute about billing, either within the provider system or with the insurance company."
Even if you act as your own advocate, having your records handy at the time of billing can help. "Most patients are intimidated when I first mention auditing an EOB or understanding coding, but patients are ultimately responsible to make sure the billing is correct," Freeman says. "Whether you audit the medical and financial records yourself or ask someone for help, your copies of the medical record will enable the answers to be found and your costs to be accurate."
