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Understanding hospital billing: A sample bill experiment with hospitals in Hampton Roads

The 13News Now Investigates team asked for a sample itemized bill for a non-complicated childbirth, here's what we discovered about hospital billing.

NORFOLK, Va. — Hospital bills can be tough to read and difficult to predict, so I asked local hospitals to provide a sample itemized bill to help examine the total costs Hampton Roads residents, and their insurance companies, face daily as part of a 13News Now investigation.

After months of back-and-forth discussions, 13News Now received bills showing typical charges for an uncomplicated childbirth in local hospitals, including common services, drugs, postpartum supplies, one night of room and board and other associated costs.

The exercise led to a broader discussion about the challenges of hospital billing and the "avalanche of information" that most consumers find "impossible to navigate."

Sentara Healthcare provided a sample bill totaling $16,633. Room and Board costs more than $1,400 a night and nursery time costs more than $3,000 for two days.

DOCUMENT: Sentara Sample Bill explained

"These are pretty typical charges for an uncomplicated vaginal delivery in the hospital," Sentara Healthcare spokesman Dale Gauding said. 

Gauding is quick to point out that almost no one will pay this full amount themselves. If you’re uninsured, there are significant discounts available. And if you have health insurance, you’ll have a maximum out-of-pocket cost - the most you’ll pay regardless of the size of the bill.

“A number of specialties are going to come into play, costs are going to rise. It’s really hard to say, it’s not like buying a box of cereal," Gauding said. "Going to the hospital is a complicated affair, even for a seemingly routine procedure.”

All insurance companies are required, by law, to provide cost calculators on their websites. Hospital systems, like Sentara, claim high prices on bills without insurance adjustments can scare consumers, so they choose to not post sample bills online.

“I think that putting a sample bill like this on the website is tantamount to saying ‘this is what it’s going to cost you,' and it’s way more complicated than that," Gauding said.

13 News Now asked more than just Sentara for information. 

Chesapeake Regional Healthcare first said it would be impossible to provide a sample itemized bill because there are “too many variables.” After some digging, the Investigative Team found an itemized bill for an uncomplicated childbirth on its website, showing it would cost $22,412.

We followed up and asked Chesapeake Regional to break down some of the costs. A spokeswoman responded and said the organization is “correcting inconsistencies” and asked us to “disregard the data” that is still available on the hospital's website as of September 23, 2019. Chesapeake Regional did not respond to any questions asking for clarification about listed costs.

DOCUMENT: Chesapeake Regional Delivery Estimate

The Bon Secours Health System declined to provide any information, saying it would “oversimplify the complex nature” of hospital billing. 

Starting this year, hospitals are now required to post their 'chargemasters.’ However, the extensive excel spreadsheets with thousands of prices for each hospital service are far from consumer-friendly.

DOCUMENT: Sentara Hospitals 'Chargemaster'

“I think we would say there is no benefit to consumers to looking at the chargemaster," Gauding said. "We think it adds to the confusion about healthcare costs."

Gauding said he doesn't know how to find the middle ground between transparency and adding to consumer confusion. 

“I don’t know where [that middle ground] is, and I don’t think anybody in the business knows where it is right now," he said.

He believes proposals to put ultimate consumer pricing on hospital websites would be too difficult and involve thousands of health plan designs.

“I think that’s an avalanche of information that most people would find very difficult to navigate," he said. "We didn't invent the system we work in, but we have to function within it. And until something better comes along, this is what we're stuck with.

Gauding’s takeaway for navigating hospital billing is this: Find the cost calculator on your health insurance plan’s website to estimate your bill and find the maximum that you would pay. And if you’re uninsured, investigate the hospital’s assistance plans before you might need them.


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