You never know when you or a family member will end up in the emergency room or find out that an expensive procedure is necessary. And while you’re busy worrying about these health issues, you will most likely have the added stress of medical bills coming your way, adding insult to injury. I know this first hand because I was hospitalized for a week in 2010, and the medical bills were astronomical. The hospital alone billed my insurance over $200,000 and that didn’t include the doctors’ fees, x-rays, blood tests, etc. Also when my son died of a brain aneurysm after only 6 hours in the emergency room we again had medical bills to deal with in the aftermath.
I’ve been a medical biller for 16 years and even I learned some things from these experiences. I’ve been on the patient side of things as well as the health care provider side. My experience at both ends allows me to share my knowledge with you. Here are some ways to make sure you’re not being overcharged, and to even save money on your medical bills.
Paying deductibles beforehand
Collecting deductibles up front is a policy many offices have. If you have a high deductible that has not yet been met for the year and you have a procedure or test scheduled, the doctor’s office or facility may calculate what the patient responsibility will be ahead of time and ask for payment up front. If it is their policy there is not much you can do to avoid this. However, I recommend contacting your insurance company yourself ahead of time and asking them what you will owe to make sure it matches with what the doctor’s office is telling you.
In order to do this you will need to ask your doctor’s office for two pieces of information. 1. Their tax ID number and 2. The procedure codes they will be billing. With this information your insurance company will be able to tell you what your responsibility will be. If what they tell you differs from the amount the doctor’s office is trying to collect, call the office back. Let them know your insurance gave you a different dollar amount. Ask them to give your insurance a call to get it straightened out. Your insurance will even do a 3 way call if you request it. That way you can make sure that all parties are on the same page.
Paying deductibles after a service, but before your insurance has processed the claim
A day or two after my hospital stay I got a call from the hospital letting me know that my remaining deductible was $5,000, but if I paid them today they would give me a $500 discount. Luckily we had the funds, so I paid the $4,500 and was happy to have at least saved some money. What I didn’t know was that the hospital then proceeded to take their sweet time billing my insurance company. So long that the insurance claims from all the doctors, x-rays, labs, and everything else were billed first. My deductible was applied to those claims, not the hospital claim. I ended up owing the hospital nothing and had to wait a while for them to issue me a refund.
I learned my lesson and now I’m passing it on to all of you. If a hospital or office tries to collect money from you after services were performed but before billing your insurance, tell them you’d prefer to wait until after all claims have been processed and your insurance has informed you of how much you owe. A discount can be enticing, but in this case it’s better to skip the offer and avoid paying the wrong provider.
Examine your medical bills carefully
When you receive a medical bill, don’t just pay it right away trusting that it’s correct. Always double check with your insurance to make sure it matches what they say you should owe. When an insurance company is finished processing a claim they produce an explanation of benefits. This has a breakdown of everything that was charged, what they paid, and how much you owe, if anything. This will either be sent to you in the mail or you can always log on to the insurance company website and access the claims information online.
If your bill doesn’t match what your explanation of benefits shows you owe, call the hospital or doctor’s office and tell them you think your bill is incorrect. If they tell you what they billed you is accurate, get your insurance involved. Again, most insurance companies will gladly do a 3 way call between you, them, and the provider. This will make it easier to get the issue straightened out quickly. Your doctor can only bill you what the insurance tells them to bill. The insurance company has the final say!
If you can, opt for a payment plan
I’m usually not one to encourage payment plans, but medical bills are a rare exception. As a medical biller I know most doctor’s offices don’t charge interest on payment plans, and they’d rather work with you on creating a payment plan than bill you for months without hearing from you. They appreciate that you’re trying to get the balance paid off. Besides, they can’t send your account to collections if you’re making consistent payments, no matter how old the balance is.
A medical biller’s goal is to collect the money as quickly as possible. Although they may be willing to have you set up a payment plan (because they’d rather collect a little each month from you than risk you never paying them at all), they’d much rather collect the entire balance up front. They’d probably be willing to give you a discount (if you asked for one) in exchange for immediate payment in full.
The trick to getting a discount
You can try calling them, telling them money is tight and asking for a discount if you pay today. Some will take you up on this, others will not. I’ve found the thing to do is call them and ask for a payment plan. The longer you can stretch the plan out the better. Then after a few months of making your consistent payments, call them again and tell them you’d really like to get out from under this now and you’re willing to pay the remaining balance today if they can give you a discount. Most offices would rather get less money immediately than get the full amount over the course of several months.
I’ve even set up payment plans myself even though I had enough money to pay the full bill, just so that I could call back a few months later and request a discount if I paid the remaining balance immediately.
A word of caution on medical bills
Just make sure you will not be charged interest while on a payment plan. If the doctor’s office does charge interest then it will practically negate the eventual discount. In that case it’s better to simply pay the entire balance right away. But it never hurts to ask for a discount anyway!
When you receive a medical bill, don’t just pay it right away trusting that it’s correct. Always double check with your insurance! Share on XEven though medical bills are unavoidable, with some research, due diligence, and a few phone calls, you can make sure you never pay more than is required. Here’s hoping you all stay healthy enough to avoid getting a medical bill for a long time! But if you do, and you have any questions about how to handle your medical bills, please leave me a comment or shoot me an email and I’ll be happy to help!