Manchin: Health Bills Need Checkup

WHEELING – After Gov. Joe Manchin had knee replacement surgery, he said the hardest part wasn’t his recovery – it was trying to decode the many medical bills he received in the mail.

”Not only was I not sure of the reason for each of the separate bills, I simply couldn’t determine the final cost of my surgery because there were so many different parties involved,” Manchin wrote in an August 2007 column. ”It also seemed ridiculous that it took months for me to receive some of the statements.”

This experience prompted Manchin to launch a Web site,, to help Mountain State residents get information about procedures and services offered at various facilities before making a choice. Hospitals, he noted, voluntarily file their information.

Manchin said Friday that he still is baffled by how complicated medical bills can be. And figuring out a way to consolidate those bills should be part of the national health care debate, he believes.

He advised that hospitals may want to handle bills like a construction company. In the construction business, he said, a contractor often hires his own subcontractors to complete various jobs, such as electrical work. But only one bill is sent to the person paying for the work.

”As far as I’m concerned, this is one of the easiest parts,” Manchin said of reforming health care bills.

But local hospital officials said patients receiving separate bills for one hospital stay or procedure is common practice at medical facilities across the United States, not just in West Virginia.

For example, if one enters the hospital to give birth, there likely would be one bill from the hospital for the procedure, room and tests. But since the patient’s obstetrician/ gynecologist is not an employee of the hospital, a separate bill would be sent for their services, said Anita Petri, corporate controller for both Ohio Valley Medical Center in Wheeling and East Ohio Regional Hospital in Martins Ferry.

”It does tend to be confusing. It’s the nature of the business,” Petri said.

And to change that nature, Petri said, would involve restructuring how insurance companies handle reimbursements.

”We have a financial counselor in the main lobby that’s available to assist patients with bills,” Petri said. ”They can at least make a call and decipher which bill is for what.”

And as the nation continues to debate what health care reform should look like, Petri said though billing issues can be tedious, she believes ”there are more significant issues that should be addressed first.” She declined to give examples of those issues.

Petri said most bills should contain a customer service number for people to call and ask questions. But some people, she noted, have a tendency to put off even looking at their bills.

”Don’t throw them in a corner and ignore them,” Petri said. ”We have financial counselors if you need assistance deciphering medical bills.”

In his column, Manchin states people aren’t just patients, but health care consumers. And consumers, he said, deserve to know what a service will cost ahead of time.

Petri said her hospitals can give cost estimates, but the nature of each patient’s care ”can be very different.”

Wheeling Hospital spokesman Gregg Warren said many people are under the impression that doctors work for hospitals, but most do not.

”They are private physicians who have been granted permission by hospitals to provide care in those hospitals. Therefore, the doctors, operating as a private business, handle their own billing. As businesses, independent of hospitals, they are responsible for the billing of their services,” Warren said.

He compared hospital services to that of a shopping mall.

”Think of being a patient in a hospital as being a customer in a mall. You can purchase items from several stores, but the mall doesn’t bill you. Each store bills you. The stores are using the mall as their base of operation, just as doctors use the hospital as theirs, Warren said. ”The number of bills a person receives depends on the number of medical providers treating the patient during their hospital stay.”

Warren conceded that receiving multiple bills can be confusing for a patient.

”Our business office’s patient account representatives work closely with patients to assist them with any billing questions they may have,” he said.