CHECK THE NUMBERS
While you shouldn’t ignore the bill and hope it goes away, you also shouldn’t rush to pay it without first comprehending the details. “Especially if it’s a really high bill, consider it like an opening offer,” advises Caitlin Donovan, a representative for the charitable Patient Advocate Foundation, which aids seriously or persistently ill people in resolving financial and insurance issues.
Medical bills may contain numerous mistakes. Additionally, they might have been delivered before insurance coverage was determined.
Donovan advises comparing the invoice to the summary of benefits provided by your insurance company. It’s a letter the insurer gives you outlining how your insurance will cover the treatment you received. Based on your deductible or the plan’s out-of-pocket maximum, it might help you estimate how much you might still owe.
Call the insurance company and the hospital for an explanation if something seems strange. It’s possible that someone at the hospital copied or entered the incorrect code for the treatment you received. To determine if that occurred, ask the hospital for an itemized invoice. However, Donovan warned that these bills can often be confusing to understand or contain inconsistencies unrelated to the fee.
KNOW THE LAW
The No Surprises Act, which was introduced last year, adds another degree of security. Patients should confirm that their healthcare provider is abiding by that law.
In many cases, it stops doctors or hospitals from charging insured patients more when the care providers are outside of their insurer’s coverage network.
The rule essentially mandates that patients receive in-network coverage with no additional charge from the provider, providing protection for the majority of emergency care. Additionally, when a patient is treated at an in-network hospital, they are shielded from expensive lab fees or anesthesia services provided by an out-of-network physician.
A “No Surprises Help Desk” has been set up by the Centre’s for Medicare and Medicaid Services for customers who are unsure whether their bill complies with the law. They can either make a complaint online or by calling (800) 985-3059.
SEEK OUTSIDE HELP
Numerous for-profit and charity organizations exist that can assist people in managing their medical expenditures. After receiving a kidney transplant, David White spent over $2,000 on basic lab tests. The Patient Advocate Foundation assisted him in recovering those costs. A case manager informed White that problems with the claim were being caused by a government database and that similar issues had previously affected persons in White’s circumstances. She also assisted him in filing the necessary paperwork to fix the error.
“Every single penny that I paid out was refunded,” claimed the 61-year-old White, a volunteer foundation board member. There is simply no way that I could solve this problem on my own.
The foundation provides a list of prospective online providers for assistance with medical or prescription bill payments. A state attorney general’s office, which may have a health advocacy unit or a consumer protection division, is another potential source of outside assistance.
John McNamara, a primary assistant director of the federal Consumer Financial Protection Bureau, advised consumers to be extremely cautious of any type of medical credit card that a provider would provide. If the debt isn’t entirely paid off within a specific amount of time, such cards can have high interest rates or other conditions that could financially harm the patient. Additionally, patients who accept that offer can miss out on additional financial aid or their insurer might not be billed, according to McNamara.
BARGAIN AND BUDGET
You’ve double-checked the work and enquired about discounts and financial aid. You might now have to face a final bill. Inquire about a payment schedule. Numerous hospitals provide solutions with zero percent interest or very cheap rates. However, before doing that, review your budget to see what kind of payment you can afford. Look into income-based programmes that could assist with rent or utility costs. Donovan pointed out that those who accept a monthly bill that proves to be too high risk having that debt go into collections if they are unable to make payments. Then you have a very different issue, she continued.
