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Linda Snyder - Director of Marketing
Linda Snyder - Director of Marketing
Contributor •

Are You Paying For Your Doctor's Mistakes?

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Imagine going to the hospital for a routine hernia operation. Imagine you wake up and find two incisions instead of one as expected because the surgeon operated on the wrong side and had to start over.

Imagine getting your insurance statement a few weeks later and find your insurance had been billed for both operations!

This is the true story of Kevin Baccam, a 33-year old school district controller from Urbandale, Iowa, who had his surgery in August 2005. He is suing Dr. Frederick S. Nuss and the Iowa Clinic. “It’s the principle of the thing”, said Baccum.

This is not an isolated case; there are many other medical billing horror stories, some with devastating results. And yet in many cases the patient is being billed for the doctors’ or hospitals’ mistakes.

Eleven states have adopted a policy of waiving the fee for the worst mistakes, which have been dubbed “never events“, meaning they should never happen at all. The NQF (National Quality Forum) has identified 28 never events that include surgery on the wrong part, surgery on the wrong patient, wrong surgery performed on a patient, items being left behind in a patient and a baby sent home with the wrong mother.

There’s a certain amount of finger pointing and liability issues that emerge when a doctor and/or hospital admits they made a mistake. For example, the hospital preps the patient correctly and the doctor operates on the wrong body part, should the hospital pay? Or, the hospital performs the blood tests on the wrong patient and the patient dies in surgery because he was given the incorrect blood type. Is that the doctor’s fault? It certainly isn’t the patients’ fault, yet in many instances it’s the patient who is paying for these mistakes.

In October 2008, Medicare will start hitting hospitals where it hurts. Medicare will no longer cover 8 of the most serious never events.

Other insurers are looking into this as well. All I can say, is it’s about time.