Keeping and Maintaining Hospital Bills and Records

Part 2, Chapter 5: Traditional Individual and Group Plans, Hospital Bills Page 9

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Maintaining Copies of Hospital Bills

Once a hospital bill has been paid, it's essential to maintain copies of all records related to the claim, including bills, Explanation of Benefit Statements, operative reports, and letters. Some insurance companies periodically review hospital claims, even though the bill may already have been paid. That review may include claims processed several years earlier. If the insurance company review determines that a claim was incorrectly paid to a hospital, or that the paperwork or documentation is not complete, the insurer may rescind the payment -- ask the hospital to return the money-without notifying you in advance. Once the payment has been rescinded, the hospital may request that you pay the bill in full.

You may receive the first such request from the hospital two or three years after your hospital admission. At that point, you'll need to talk with your insurer to try to immediately identify the problem, and you may need to file a claim appeal. In order to do that, you'll need the records. If you haven't kept copies of those records, you'll have to try to obtain them from the insurer and the hospital billing office. However, after two or three years, those records may have been transferred to a storage area or placed on microfiche. It could take months to obtain copies.

If you keep copies of all hospital records, in many cases you may be able to resolve such problems quickly. For example, I recently helped a reader resolve a problem that involved a bill related to a hospital stay for an extended period of time more than five years earlier. In that case, the insurer had paid most of the bill. However, there was still a balance of almost $10,000. The insurer continued to deny the claim. Five years later, the hospital sent the reader a notice requesting immediate payment.

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