Twice a week for the past three months, Consumerist reader P. has been going to her hospital’s gym for brief, doctor-ordered cardio workouts. Her insurance isn’t footing the bill and each session is only $9.00, so she’s been assuming that the hospital was wisely waiting until her tab reached an amount worth billing before it sent an invoice. Not exactly…

“I thought the mailman had accidentally put the entire block’s power bills into my mailbox,” she tells Consumerist about checking her mail the other day and finding 20 envelopes wrapped in a rubber band.

But all those envelopes were for her, and they were all from the hospital. Twenty separate invoices for $9.00 each.

And this wasn’t an issue of a backlog at the post office or someone at the hospital mail room forgetting to send them out. All letters are first notices, all issued on the same date.

P. says she has no intention of remitting separate payments for each invoice, but she also knows the hospital — or more likely, whatever third-party billing company is handling this mess — will probably be confounded when they receive a check for $180.00 with a payment stub that only asks for nine dollars.

But when the hospital bills like this, it is just begging for a patient to miss one of the bills. We had a chance to see the actual paper invoices and had to count three times to make sure we had the correct count of 20 separate invoices. It’s easily within the realm of believability that a patient could miss one or two of these bills.

A single bill for the full amount — or even monthly bills — would minimize the chance of a missed invoice, which means fewer people being sent to collections for pocket change, which means less money the hospital is spending on billing and collections.

If we’re going to rein in healthcare costs in this country, here is one place to start.

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