After a hospital stay you will get several papers that look alike. There is the discharge packet, the hospital bill, and an explanation from the insurer. Each one does a different job. The hospital bill tells you what was charged. The insurer's statement tells you what the insurer processed and what it will pay. Neither one tells you what your parent owes until you check them against each other.

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Ask for the itemized statement

Call the billing office and ask for an itemized statement. Ask for each charge listed by date of service, with the code and the department. A single summary total does not show you which days were billed or what was billed on them. Most hospitals publish a billing or patient financial services page with a phone number and a request process. Start there, and write down the name of the person you talk to.

Check the days against the stay

Take the discharge packet and write down the admission day and the discharge day. Then go through the itemized lines and compare the dates. Look for room or observation charges on any day your parent was not in a bed. Look for charges dated after the discharge time on the packet. Look for a service listed on a day you do not remember anyone visiting. Do not decide that any of these are errors yet. Mark them and ask.

Read the insurer's statement next

If your parent has Original Medicare, the statement is called a Medicare Summary Notice. medicare.gov explains how to read it. If your parent has a Medicare Advantage plan or a supplement, the plan sends its own explanation of benefits with different headings. Either way, match each service on the insurer's statement to a line on the itemized bill. A service on the bill with no matching line on the statement is a question to put to billing. A service on the statement that is not on the bill is a question to put to the insurer.

Ask about financial assistance before paying

Many hospitals have a financial assistance or charity care policy and an application for it. The policy is usually posted on the hospital's public site, often on the same page as the billing contact. Ask whether an application is open for this stay and what the deadline is. Ask in writing if you can, and keep the reply. You do not have to pay the first total you see while you are still checking the lines.

Keep the trail

For every call, write down the date, the name of the person, what was said, and any reference number. Put the bill, the statement, and the discharge packet in one folder. When a line is wrong, ask for a corrected statement in writing. Keep the old copy too, so you can see what changed.

Questions to ask before anyone pays

Is the amount due on this statement the same as the total on the itemized bill? Does the insurer statement show each service, and is each one marked as covered or not covered? Is there a financial assistance application, and what is its deadline? Who is on file as allowed to speak to billing about your parent, and is that person you? Which lines did you mark, and has each one been answered in writing?

You can find more about how this desk checks its sources on the Sources page.

The Itemized Bill Is a Different Paper: Ask for It Before Anything Gets Paid