Medicare and patient overbilled for bone density shot

Karen Lawson was surprised when her doctor’s office told her she had a $500 charge for her bi-annual bone density shot. Lawson spent her life working in medical billing, so she considers herself pretty sharp when it comes to understanding her medical costs.

“It was my understanding that Medicare was going to cover it and I wouldn’t have a charge, but I needed the shot so I just went ahead and paid it,” she said.

But her instincts were spot on. When she opened up her explanation of benefits summary from Medicare and from her part D supplement plan, she discovered that Lee Health billed both parts of her plan and was actually paid twice for the shot.

An explanation of benefits statement comes from your insurance provider and breaks down exactly what your plan paid and what your out of pocket cost should be for any procedure. Medical billing experts say checking that statement is the best way to find a medical billing mistake.

Submit