One thing is for sure: if you receive a medical bill, you MUST review it in detail or risk overpaying for those services. This isn’t an easy task. Most medical bills are confusing, lacking necessary details for you to ensure their accuracy. Resist the temptation to either pay them immediately or throw them in a pile of your things “to do” at some point in the future. Here are a few steps to help you take control of your medical expenses.
Step One: Be sure the bill is itemized to show the individual procedures performed
If the bill you receive doesn’t detail the services provided by each individual 5-digit procedure code, you need to call the facility and request an itemized bill. This is the only way you can confirm that you have only been billed for services that you actually received. Ask to have a hold placed on your account until you have a chance to receive and review that itemization. This way you will borrow some time before having to pay the bill and reduce the risk that you will get sent to collections for non-payment.
Step Two: Compare the itemized bill to the explanation of benefits (EOB) from your insurer
Step One lets you confirm that the correct services were billed. This step enables you to review how your insurance company processed those services. You should be able to match up each procedure code on the bill to the same code on the EOB. There you will see the billed amount, the amount allowed to be covered by your policy, and any balances to be paid by you. There should be notations that explain why a procedure was or wasn’t covered as well as how these charges were applied to your deductible, coinsurances, or copays.
Step Three: If something doesn’t make sense, you need to question it and dispute the charge
If you were charged for a service you didn’t receive, you need to call the provider and point that out. They should submit a corrected claim so that this charge is removed. If services weren’t covered by your insurance, and there is no explanation as to why, you need to call your insurance company and have them explain how they processed the services on this claim. Don’t stop asking questions until you are satisfied with the answers. If necessary, ask for a supervisor who can better address your questions. Now is not the time to be shy: it is your right to receive accurate and complete answers to your questions.
Step Four: If the charges are correct and the bill is still high, negotiate
It’s always worth asking if a provider would be willing to reduce a bill by your making immediate payment in full. Many will reduce their fees when asked, while others will insist on being paid the full amount billed. If you don’t ask you can be certain that the bill won’t be reduced. Often good things come to those who ask.