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The Vitamin C Conundrum




As healthcare costs continue to rise, it's more important now than ever for payers to be vigilant about reviewing all itemized inpatient hospital bills. The itemized bill is key to understanding the line-by-line breakdown of charges for all of the procedures and services that patients receive during their hospitalization. The universal bill (UB 04), on the other hand, is the consolidated summary of those charges, and a lot can be hidden inside the UB. Whether it’s a hospital billing mistake or a tactic to slip in additional charges, “someone has to pay if the medical billing errors go unnoticed, which is likely, since the industry lacks resources to ensure these types of bills are reviewed at the line-level”, says Ira Weintraub M.D, Chief Medical Officer at WellRithms.


Case in point, this week WellRithms received a bill for a patient admitted to a hospital after suffering a stroke. The itemized bill revealed three separate charges of $958.10 for ascorbic acid on one day and $0.62 per 500mg dose of ascorbic acid (coded differently) on the next day. “Ascorbic acid”, that’s hospital lingo for vitamin C, in case you didn’t know!


This patient was receiving nutritional support during the treatment, and the recommended daily allowance for vitamin C is 500mg per day with an upper limit of 2000mg per day. “The 500mg dose is reasonable, but the $958 charge doesn’t make any sense.”, says Dr. Weintraub. “Ascorbic acid costs about a nickel per dose, so with this hospital’s five times markup for drugs and their charge of $958, that would equal 3,832 doses! “Now, that’s one really bad cold”, he jokes.


These charges add up, but by being proactive and informed, our client avoided paying for these sour surprises as well as many others and reduced their charges on this bill by over half a million dollars.

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