Medical emergencies are often unpredictable, and it may happen to anyone, including you or your loved ones. There may be a situation when such cases need hospitalization, and in the end, you get a medical bill that you may even go bankrupt and feel helpless. However, you don't need to worry, and in such circumstances, patient advocates can offer help paying medical bills and take you out of this situation.
Here are specific tips that you can follow when you get a medical bill you cannot afford.
1. Review the Bill for Any Errors
Since the billing department of a hospital has to manage a lot of data, errors in medical bills are quite common. You might have to bear expenses for a medical procedure or treatment that you have not undergone. Even if you receive a treatment, the charges for some items may seem unusual. The insurance company may pay for some specific brands. Some of the terms and conditions in your insurance policy may change. You should review the bill carefully and keep all the statements and information that you receive from the medical care provider and record phone calls and emails that are relevant.
2. Ask For an Itemized Bill
The bill you receive should be an itemized one, that means all the services and price must be listed separately. However, hospitals usually provide a bill where the services received are summarized, and a lump sum amount is shown as the amount due. So if the bill you receive is not itemized, make a request to the hospital's billing department for an itemized bill. Ask questions if there are multiple readings for medical tests and scans since you should get charged once. Get an itemized statement to find out any problems.
3. Know About Balance Billing
If you undergo treatment or a medical procedure at a hospital, several medical professionals treat you like medical practitioners, nurses, anesthesiologists, and others. Except for your treating physician and hospital, the other medical professionals may not be present in your insurance network, and for that reason, your bill amount may be higher. That is why your insurance provider doesn't pay for the total cost of the procedures, and you receive an outstanding balance known as balance billing.
4. Check for CPT Code Errors
To determine if there is any CPT code error, you can enter your CPT (Current Procedural Terminology) codes mentioned in your medical bill in the CPT/Medicare Payment tool. That helps to detect errors like charging for a private inpatient suite instead of an outpatient suite, OT overcharges, and charging a particular service two times once under a combined CPT code and once under specific CPT code. You need to contact the facility's billing department if you notice any errors.
5. Speak To Your Medical Practitioner
If you have any doubts or confusion regarding any charges, make queries at your doctor's office, spot the errors, and ask them to review the bills. You can request your medical practitioner to hold the bill and not send it for collection until the issues get resolved. It can be done over the phone, but it requires several conservations and takes time if it is complicated.
6. Contact Your Insurer
Speak to your insurer regarding services that are not getting covered, which you thought would be. You need to find out if the insurer is missing any critical medical record or any out-of-network doctor has provided any service. You can ask your insurer about charges that they didn't cover any expenses that seem very high. You can call customer care. Also, you can request your insurer to negotiate with your medical practitioner to reduce the charges. Some insurers offer claim –resolution services.
7. Collect Evidence
When you communicate with the medical service provider and the insurance company to review your bill, you should collect the necessary documents and information to prove that your bill has errors. You can search for five-digit codes online that match with the charges in your bill and check that they reveal the procedures or services offered.
8. File Insurance Appeal
If the issues are still not resolved and your insurance claim is denied, you can make an insurance appeal within 180 days. In that case, your doctors can help you by writing a letter and providing evidence that the treatment or procedure was needed.
You can seek advice from ClaimMedic as they can extend help paying medical bills and save your time and money. The founder and CEO, Mary Daniel, is a board-certified patient advocate and patient insurance liaison with three decades of experience in medical billing and medical practice management. She helps patients and their families pay medical bills since she organizes and performs audits and negotiates medical bills.