An itemized bill shows you every good or service, when it happened, what it is, the associated billing codes, and the amount. Typically, patients do not receive an itemized bill from a hospital without first requesting it.
After an encounter with a hospital, a patient will most frequently receive two financial related statements:
- A consolidated bill from the hospital. This contains the amount due to the hospital, as well as accepted methods of payment. Consider this your invoice. Unfortunately, it does not contain detailed information of every good or service performed by the hospital.
- An explanation of benefits, if insured. This comes from your health insurance company and explains how much (if any) of the bill your insurance is covering and how much will then be left over for you. This is not a bill and there's no action required when receiving this. While it often has more detail than a consolidated bill, it, too, is insufficient to help you understand whether you're being fairly charged by the hospital.
In some cases, you may receive multiple consolidated bills from the hospital, depending on their billing department. You may also receive additional bills from specific providers (independent practices of doctors) who work at the hospital and performed care for you.
How to request an itemized bill
Make sure you have the following info handy:
- Your guarantor number
- Call the number for the hospital's billing department, typically located on the consolidated bill sent in the mail.
- Choose the relevant option to speak with a human about your bill.
- When a human picks up, ask: "I'd like an itemized statement. Could you post it to my online portal or mail me a copy directly?"
- Give your guarantor number when asked along with any other necessary personal information.
- If your bill is posted to an online portal and you're unsure if you have access to the online portal, ask the representative before hanging up how to sign-up or log-in to the online portal and how to download the itemized bill.
How to tell if you have an itemized bill
An itemized bill should have every single individual product or service your received, broken out, line by line. It should also have a procedure and/or revenue code attached to each line item.
Here's an example of an itemized bill:
