Lifewatch: Healthcare system

Reported by Claire Hosmann  email
Posted by Heather Setzler  bio | email

(WECT) -- When a patient is diagnosed with an illness, dealing with it is no easy task, especially when it comes to the expense of it all and navigating the healthcare system.

One New York City woman has learned that everything is negotiable, even healthcare.  You just need a little know-how to get started.

At age 27, Ellena Bennett knows first hand how overwhelming medical bills can be.  She first battled cancer at age 10 and again in college.

"Dealing with my bills was worse than dealing with the disease," said Bennett.

She's become an expert and has even taken a class to learn how to figure it all out but says the average consumer doesn't need to.

"It's just like when you find out there's a good sale.  You need that inside information."

Which she says is the CPTA code book.  Bennett bought a copy for $100, but even that expense isn't necessary in the age of the internet.

"There's thousands of codes in there.  Everything from your basic medical appointment to procedures, to blood work, and they update it every year.  The updates are posted online for free, and you can even now find most of the codes online."

She recommends requesting an itemized bill then looking for the diagnostic, or EOB codes.

"you match it up and say this code says that you had a comprehensive exam, they did this and this and this, and that's what they charged you for.  You didn't get any of those things, then you can go back and say I only received what's in code 9924 not 9923, so that's a price differential."

She admits she was laughed at the first time she challenged a charge but not anymore.

"If you went to a restaurant and didn't receive the right food would you pay for it? You'd raise a stink. I think the same goes for healthcare. We just don't realize we can do that."

Bennett says she's saved close to $20,000 by disputing what she considers misappropriated codes, proving that a little knowledge goes a long way.

"When I go into the hospital, now I know how much things cost and I know right now I'm not insured. So I'm not going to want to pay a huge amount, so I'll almost like a la carte medicine. I want this, this and this and this is why."

Bennett says no one is alone. If you have insurance, you can ask your company for a case manager to help you navigate the system. If you don't, Bennett says your local hospital should have a social worker or case worker who can help.