Healthcare is expensive, and medical bills are confusing. Plus, the added complication of the pandemic can result in surprises in the form of medical bills for services rendered. But that doesn’t mean you have to just accept the charges and pay them — at least not without a bit of legwork on your part.
“Make sure to go over your medical bills for accuracy,” said Rafael Rubio, president of Stable Retirement Planners in Southfield, Michigan. “Confirm that all bills were sent to your insurance first and then find out why your insurance didn’t cover some of the bills. Due diligence is important here, because the one who is mostly impacted here is you and your family. After you do your thorough research, you will have a clear picture as to what you actually owe and you can move on from there.”
Don’t pay more than you actually owe: Here are the steps you can take to avoid healthcare expense mistakes.
Check To See If the Bill Was Submitted To Your Insurance Company
While you would expect any medical bills you receive in the mail to already have been submitted to your insurance company, it’s worth double-checking. If not, the bill you receive could reflect a much larger amount because it would include the portion the insurance company was supposed to cover.
Check To See If You Recognize All of the Providers and Charges
Compare the provider’s names and connected charges on the medical bills you receive to the care you recall receiving. If something doesn’t match up, contact your provider to inquire. Also, check the dates to make sure you aren’t being billed for care you didn’t receive from a provider on a certain date.
Investigate Whether COVID-19 Testing You Received Should Be Covered
Another thing to note is that your insurance company’s policy regarding covering COVID-19 viral and antibody testing may have changed since the beginning of the pandemic. If you see charges for COVID-19 testing, call the provider to confirm that the bill for such testing was processed under your insurer’s coverage policy when you received the test — not months later when the policy may have changed.
Consider If You Should Request an Itemized Breakdown of Charges
While you probably do not need an itemized breakdown of charges for a simple office visit to your provider, you should request an itemized list of charges for anything more than that, such as if you had an operation or surgery. This will make it easier to verify the charges and make sure you’re only paying for what you owe.
Search Codes for Services That Weren’t Covered By Your Insurance
Your provider’s billing department attaches a medical billing code to each procedure so that your insurer can determine whether it is covered under your policy. Use a tool like Find-A-Code to verify that the medical billing codes that are listed on your bill for unpaid procedures are truly not covered. It’s possible that the code entered by your provider is the wrong match for the procedure, and once the correct code is entered, your insurance will cover the procedure.
Attempt To Dispute Charges Related to an Ambulance Ride Due to a Suspected or Confirmed Case of the Coronavirus
Sometimes city-run ambulances do not contract with private health insurance plans, which means that you could receive a surprise bill — of sometimes thousands of dollars — for the ambulance ride. But according to the March 2020 CARES Act, ambulance services are not allowed to balance bill you for care or services if you have a suspected or confirmed case of COVID-19. If you receive this type of bill, check to see if the ambulance service received relief funds from the federal government. If so, you have grounds to dispute the charges.
Also, check your state laws. There may be a law that prohibits surprise billing from ground ambulance services.
If You Have a High Deductible Health Plan, Review Any Charges for Telehealth Services
According, to the CARES Act, if you have a high deductible health plan, telehealth or other remote healthcare services provided on or after Jan. 1, 2020, should be covered either without a deductible or with a deductible that’s less than the minimal annual deductible otherwise required by law. This temporary coverage only applies to plan years beginning on or before Dec. 31, 2021.
Make an Effort To Negotiate the Bill
If you find that the charges are indeed valid but you aren’t able to pay them all upfront, consider trying to negotiate the bill to a lower price.
“Before succumbing to the medical debts you have accrued, make sure to contact the medical facility that has billed you,” Rubio said. “Most facilities are very understanding and are willing to work with you on a payment plan. Be open about your income, assets and budget plan. In doing so, these facilities will be more responsive to helping work with you. Make sure to contact these facilities and not ignore the repeated billings they send you. If you ignore them for too long, they will turn over your debt to debt collectors, which would make the negotiation more difficult.”
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