Oil companies have nothing on hospitals when it comes to price gouging. Here’s how you’re being ripped off.

One recent report found glaring — and sometimes fraudulent — overcharges on nine out of 10 hospital bills.  While many of these charges are accidental, some are not. The National Health Care Anti-Fraud Association estimates the cost of fraudulent billing at $51 billion per year.

In the majority of cases, the mistakes are human error that goes undetected.  For instance, it’s not uncommon to see data entry errors — such as charging $70 for a 70-cent  I.V. tube or repeating an item on an itemized bill.   

An example of fraud would be the use of misleading descriptions to justify outrageous charges. An MSN investigation found an instance of a hospital charging $129 for a “mucous recovery system” – which turned out to be a box of tissues next to a patient’s bed.

Even when keyed correctly and described properly,  hospitals charge different payers different rates for the same services, items and supplies. Most times that price is inflated over the cost of the item. Often, people without insurance are charged the highest rates.  People with health insurance pay a specified amount dictated by the insurer’s contract with the hospital. Even with the same carrier, there are often price variations from one plan design to another.

Who pays the price in the end? Your company (via higher premiums) and employees (via inflated deductibles). Insurers pass the price right along.  Here are seven keys to avoid being taken for a ride, saving an average $1,300 per hospital stay:

1.  Review coverage. If the hospital visit is a non-emergency, check your health plan’s policy to see what it will cover and how much it’ll pay.

2.  Call in advance. Phone the hospital billing department, ask what they charge for an inpatient stay and what room charges cover. (If tissues aren’t included, bring your own.)

3.  Check participation. Make sure everyone treating you – including the anesthesiologist or radiologist – participates in the insurance plan.

4.  Ask doc about prescriptions. The employee may be allowed to bring prescriptions from home and avoid paying for the hospital pharmacy to dispense the same medication.

5.  Keep treatment log. If possible, keep a log of tests, meds and treatments given during the visit. If not, ask a loved one to make a record.

6.  Examine EOB. This is where the log comes in handy. Compare the record to the covered services listed on the explanation of benefits, and

7.  Double-check bill. Unless the insurance deductible has been met, the hospital will bill the patient. Compare the bill to the estimate, the treatment log and the EOB. If there are ambiguous charges –like “lab fees” and “miscellaneous” – ask for an itemized bill. Every state requires hospitals to provide them on request.