How to Avoid Costly Medical Bills

Medical billing errors are common and can be costly if they aren’t caught. According to medical experts, 40 to 80 percent of medical bills contain errors, and Kaiser Health News estimates that nearly $68 billion in healthcare spending is lost due to billing mistakes each year.

Martin Rosen, Health Advocate’s Executive Vice President, Chief Marketing Officer and Cofounder, recently appeared on The Willis Report, a FOX Business TV show that focuses on consumer and personal finance issues.  The Willis Report ran a week-long series called “A User’s Guide to Healthcare,” aimed at helping viewers unravel the complexities of the healthcare system and become empowered consumers. Martin served as an expert source to discuss the most common errors found in medical bills and how consumers can better understand medical bills and avoid mistakes.  To view Martin’s appearance on The Willis Report, visit http://www.healthadvocate.com/tv.aspx?v=20130717-FoxBusiness

Health Advocate offers the following tips to help you look out for errors and avoid getting costly medical bills:

Don’t wait to open your Explanation of Benefits (EOB). Your EOB lists a number of items, including patient’s name, provider’s name, type of procedure, date of service, charges to the provider, the cost covered by the insurer and what you may owe.

You’ll want to open up the EOB as soon as it arrives in the mail to make sure everything is correct. If there is an error, such as wrong date of service or you’ve been charged twice for a procedure, it’s best to resolve it quickly. It’s very important to open the envelope as soon as you receive it—if you wait too long to read it or handle any errors, you could lose your right of appeal. The deadline for appealing a claim is typically 45 days.

Be informed.  If you are insured, know the details of what your health insurance plan covers.  Familiarize yourself with the details of your insurance benefits.  Understand how much you’re responsible for when it comes to your deductible, co-pays, and co-insurance.  Learn what services are and aren’t covered under your plan. Being insured does not always mean that all your medical costs are covered. 

Verify that the provider you choose is “in-network.”  Make sure that any labs your provider may use for various tests are also considered in-network.  If the provider and/or the lab and facility the provider is using are in-network, your medical bills will be less costly than out-of-network labs/facilities.

Read your bill carefully. If you’ve had a hospital stay, ask for an itemized bill at the conclusion of your visit.  Be aware that this may not include information on what you or your insurer will be asked to pay, but it could help you spot major errors on your bills.

Ask the hospital for a copy of your pharmacy ledger. This details what drugs you were given through the course of your stay and your medical chart. Look these over carefully to make sure the hospital isn’t charging you for any drugs you didn’t actually take.

Find an advocate.If you are a Health Advocate member and need help understanding a medical bill or EOB, reviewing and explaining your benefits information, finding an in-network provider, making sure your bill contains no errors, filing a claim, and more, give us a call—our Personal Health Advocates are happy to assist you!

Helpful Tips for Handling Medical Bills

A recent study conducted by the American Journal of Public Health said that of the 83 percent of participants who had health insurance, nearly 27 percent of them had difficulty paying their medical bills.  Common reasons for people not paying medical bills include confusion about what exactly they’re responsible for owing  ), and/or they can’t afford the larger than expected price tag.

Fortunately, there are several ways you can avoid incurring large medical bills. Health Advocate Inc., an advocacy and assistance company that helps people navigate the healthcare system, offers the following tips:

Be informed.  Know the details of what your health insurance plan covers.  Being insured does not always mean that all of your medical costs are covered. Ask your insurer what kind of out-of-pocket expenses you can expect.

How Health Advocate can help: A Personal Health Advocate will research your insurance policy and determine your out-of-pocket costs for doctor visits, medical procedures, lab work, etc.  

Verify that the provider you choose is “in-network.”  Make sure that any labs your provider may use for various tests are also considered in-network.  If the provider and/or the lab and facility the provider is using are in-network, your medical bills will be less costly than out-of-network labs/facilities.

How Health Advocate can help: If you’re looking for an “in-network” provider, your Personal Health Advocate can locate one in your area. Your Personal Health Advocate can even schedule an appointment for you and transfer your medical records.

Do your homework. Costs for medical procedures can vary dramatically, depending on the doctor and facility where they are performed. For example, an MRI at a large teaching hospital is likely to be more costly than having the very same procedure done at a stand-alone facility. Start by researching different hospitals and facilities to comparison-shop.

How Health Advocate can help: Using Health Advocate’s pricing tool, Health Cost Estimator (HCE), your Personal Health Advocate can provide you with a list of providers in your zip code and the estimated cost of the procedure. You can also access Health Cost Estimator yourself. Simply go to your member website (HealthAdvocate.com/members) or download our FREE mobile app (from Apple or Google Play) and access HCE right on your tablet or smartphone! Plus, one touch connects you to a Personal Health Advocate for one-on-one help.

Read your bill carefully. Ask for an itemized bill. This could help you spot major errors on your bills.  For example, does the bill indicate that you received a treatment or procedure that you didn’t actually receive?  Are you being charged twice? A Consumer Reports Health survey said that 80 percent of medical bills have errors.

How Health Advocate can help: A Personal Health Advocate can check for errors on your bill and if found, can help resolve the problem.    

Talk to your doctor. Providers consider your financial status when recommending care. Let them know that costs are important to you. Discuss a payment plan with your physician.

How Health Advocate can help: If you are having a difficult time paying a doctor bill, your Personal Health Advocate can work out an agreement with your provider, such as an setting up a payment plan on your behalf.

Remember, if you are a Health Advocate member, you can reach out to us for help.  Our Personal Health Advocates can estimate costs of common treatments and procedures, locate in-network doctors, resolve insurance claims, assist with correcting medical billing errors, and much more. 

Worried about big medical bills? Try these handy tips

As healthcare costs rise, many people are swamped with medical bills and other health expenses. While most have insurance, larger deductibles, copays and other costs can still add up to big bucks.

In a study conducted by the American Journal of Public Health, of the 83 percent of participants who had health insurance, nearly 27 percent of them said they had difficulty paying their medical bills.

Nowadays it’s crucial to be a smart and savvy healthcare shopper, especially in these tough economic times. What many don’t realize is that there are several ways to take control and lower your healthcare costs:

• Do your homework.  Costs for medical procedures can vary dramatically, depending on the facility where they are performed. You can research different hospitals and facilities to comparison-shop prices for procedures. Just reviewing and comparing costs is one important step in potentially saving money and making the best use of your healthcare dollar.
• Always stay in-network.  When possible, stick with a doctor under your insurance plan. Using an in-network provider will help you to avoid large out-of-pocket charges.
• Talk to your doctor.  Providers consider your financial status when recommending care. Let them know the costs are important to you. Discuss a payment plan with your physician. A whopping 61 percent of adults who asked their doctor for a discount got one.
• You got charged.  Insurance will not cover the entire cost of the medical procedure you received if the provider is not in your preferred network leaving you with large out-of-pocket expenses. Some providers will give you a lower rate if you pay in cash. You can also make arrangements with the billing department. They may discount what you owe or work with you to make monthly payment arrangements.
• Look out for errors.  According to Consumer Reports Health, 80 percent of medical bills have errors. Some common errors include: incorrect coding, wrong names, addresses, birth dates and social security numbers. Also make sure you are only being billed for the treatment you received.
• Don't give up.  Dispute any charges you think you should not have to pay. Work with the provider’s billing department until you come up with a resolution.
• Get a third party involved.  It doesn’t hurt to get help from a health advocate. They can help you talk to the insurance company and walk you through an appeal process if necessary.

The important thing to remember is to be an informed patient. If you find that you need help, you can always consult a Health Advocate Personal Health Advocate who can help you locate providers, negotiate on your behalf, identify errors on medical bills, compare costs for procedures, file an appeal (if warranted), and much more . If you are not a Health Advocate member, you can still get help. Just call and speak to an advocate through our direct-to-consumer division Health Proponent.