HOW TO UNDERSTAND YOUR MEDICAL BILLS
by: Remie Longbrake | published: September 13, 2021
Look for red flags
First and foremost, establish that this is a legitimate medical bill. There are unfortunate cases where scammers can make very official and urgent-looking medical bills. The scary part is that they might know information about what hospitals you’ve been to, who your primary care provider is, and so on. Always verify with your doctor or the hospital that they sent this bill, which they will happily verify with an invoice or billing number.
Check and correct information
It is imperative to ensure the information on your medical bill is accurate, for both your insurance coverage and legal reasons. Read the contact information and insurance information carefully. Pull out a red pen, and mark any mistakes so you can remember when you speak to the biller.
Your information
Make sure your bill uses your full legal name and has your current address (or at least the address reflected on your insurance). Any misspellings or an incorrect address should be marked accordingly. It can’t be emphasized enough that it’s important your name and address match your insurance if you’re going to use it to pay for the bill.
Insurance information
Check that the policy number, insurance company, and coverage are accurate. If you anticipated your insurance covering more than it did, call them immediately to ask about it. If they agree with you, mark this on the bill and talk to the biller to review if they billed your insurance correctly. Being billed for an out-of-network provider is common.
Dates and providers
You should already keep track of your doctor’s contact information and the dates of previous appointments or treatments. This makes it easier to verify that the bill accurately reflects the provider and date of service. If the doctor is incorrect, even if it’s a different doctor within the practice, have this corrected. The practitioner type can affect the amount on your bill. For example, if you saw a general physician and not a specialist, this should be corrected.
Search the billing codes
Billing codes make it easier for doctors to speak to insurers. Every procedure, treatment, visit, or otherwise, has a code. Use a search engine such as findacode.com to review each code and verify its accuracy to the bill. Sometimes the wrong medical code is listed, which can easily be disputed with after-visit summaries from your doctor. You may need to communicate with your insurance to ask how a procedure would need to be coded to be covered. A doctor’s office can resubmit the claim with codes covered by your insurance provider.
Get an itemized list
An item-by-item breakdown of procedures and services can resolve a lot of billing errors. You can visually see the cost of each item and notice if a quantity is inaccurate or if there are extra items that you should not be billed for. Extra 0’s are a common medical billing error, where a one hundred dollar item is listed as one thousand.
Negotiate
Yes, you can negotiate your medical bills. Head to healthcarebluebook.com or fairhealthconsumer.org to gather information on reasonable, industry standard pricing for any health services. Hospitals and practices are willing to negotiate if you present your numbers and are unlikely to argue back. It’s not worth the back and forth for them, so their loss is your gain.
Be timely
Medical debt can affect your credit score. However, anything less than six months old won’t reflect on a credit report. Because of this, you should take care of the bill ASAP so that your provider doesn’t send it to a collection agency.
Be proactive about your medical bills, and discuss costs directly with the provider before you leave the office or a telehealth appointment. Mistakes happen, so use these tips to be an informed consumer.