A Hypothetical Hospital Bill For Use in Health Insurance Claims
Part 2, Chapter 5: Traditional Individual and Group Plans, Hospital Bills Page 4
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Table 12: A Hypothetical Hospital Bill
Hospital: (Name of hospital)
Insurer: (Name of insurance company)
Insured/Patient: (Name of the policyholder and the patient)
Patient's Insurance Company ID Number: (Identification number)
Procedure Code: (Numerical procedure code)
Description |
Cost |
Comments |
| Med-Surg-Semi-PM | $6,000 | 6 |
| Phrmcy | $1,900 | |
| Med Supplies | $4,120 | |
| Med Tests | $3,573 | |
| X-ray | $57 | |
| CT | $1,500 | |
| OR | $1,196 | |
| Blood | $251 | |
| U-S | $1,620 | |
| Recvry | $1,100 | |
| Tel | $120 | 6 |
When you review your hospital bill, make certain you under stand each of the items listed. If there appears to be an error, notify both the hospital and the insurance company as soon as possible. That notification should be made in writing, not by telephone, so that there is a permanent record of the report. Be certain to keep a copy of your letter.
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