Have you or a family member recently had a medical emergency, needed surgery or been hospitalized? If so, you may know the feeling of confusion, stress and frustration that occurs when the bills start arriving in your mailbox. What do you do? How much do you owe? How in the world are you going to pay?
Step 1: Understand your insurance benefits. You need to know what’s covered by insurance and what’s not. All policies include a summary of benefits that will explain how different types of services are paid. This information can be helpful when you’re deciding on a doctor and when you’re reviewing the payments made by your insurance company. The more knowledge you have about your coverage the more likely you are to obtain the benefits you’ve paid for.
Step 2: Get organized. Because bills are paid at different times and at different rates depending on the type of service and the provider, we recommend keeping a file of everything you receive for the services you had performed. They’ll be Explanation of Benefits (EOBs) documents from the insurance company and bills from the providers. Match the payments and the bills by date of service so you’ll be able to review the charges and the insurance payments together to verify that the doctors are charging you accurately. If you’re unable to determine the exact charges filed to the insurance company, request an itemized bill so you can review it in more detail to determine its accuracy.
Step 3: Review your itemized bill for billing errors. Mistakes are often made by the provider’s office, which may bill for incorrect services or even for procedures that were never performed. The insurance company can also make mistakes; they may deny a claim because the procedure is non-covered, is not medically necessary, or the provider of the service is not in network when you’ve been told by the provider they are. Most insurance companies deny claims and count on the “hassle factor,” knowing it’s easier for you to pay the claim than appeal their decision. Don’t be discouraged. Appealing a claim is straightforward, and instructions are generally detailed on the back of the Explanation of Benefits (EOB.) A little patience and perseverance can save you money.
Step 4: Negotiate if you can’t pay your bill. Once you know the amount due from the provider of services is correct, be aware that it is often possible to negotiate the bill to a lower amount. Be polite and respectful and explain that you aren’t trying to get out of paying, you’re just asking if they will accept less money based on what you can afford to pay. Administrators can be pretty understanding and compassionate when you are thankful, honest and realistic about your situation. And remember, most medical providers don’t charge interest. As long as you’re willing to make a consistent payment every month they will keep your account in an active status.
Step 5: Hire a Medical Billing Advocate. If you’re overwhelmed, confused or frustrated, ClaimMedic can help! Because our specialists have spent years in the medical billing business we have the expertise to audit your bills and negotiate on your behalf. You’ll enjoy the peace of mind knowing we’re saving you time, frustration and money. Call us at 888-988-2985 for a free consultation about how we can meet your personal needs.