Health insurance can be perplexing, and people often make dangerous assumptions about what services are covered by their policies. Unfortunately, this frequently results in patients incurring hundreds, if not thousands of dollars in medical bills. Aimed at providing people with the information they need to obtain quality healthcare at the best price, the recently released book, Get What’s Yours for Health Care by Philip Moeller, features strategic guidance from one of the nation’s leading authorities on medical billing and advocacy — Systemedic’s principal, Susan Null.

With extensive experience advocating for the rights of patients who have received excessive medical bills, Susan is committed to educating people about health insurance and medical billing practices. Here are the three key pieces of advice she shares in the book.

1.     Be Proactive and Plan Ahead

Susan’s depth of knowledge and expertise are specifically highlighted in the chapter of the book entitled, “How to Fight Back.” Offering critical insight, Susan urges patients to have a complete understanding of what will be covered by their health insurance plans before they seek medical services. Rather than assume a procedure or service will be covered simply because you have insurance, it’s essential to do a little homework first to know how you will be impacted financially.

Importantly, patients should know that they don’t need to fall victim to unfair billing practices — especially if it’s possible to plan ahead. With a focus on empowering people with the knowledge they need to make informed decisions concerning their healthcare, Susan recommends that patients take the following proactive measures to avoid excessive medical bills:

  • Call the provider in advance to find out what billing codes will be used for your specific procedure
  • Contact the insurance company and ask if the codes are covered
  • Confirm what amount insurance will pay and how much will be your responsibility

Doing your diligence ahead of time can potentially save you a significant amount of money in the long run.

2.     Ask the Insurance Company Whether the Call is Being Recorded

Susan advises that when patients inquire with the insurance company concerning what’s covered under their policies, they should ask whether the call is being recorded. Although the insurance company might put up a fight if you try to obtain the recording, it can be useful if a dispute later arises concerning anything you were told by the representative. Also, make sure to take good notes — write down the name of the person with whom you spoke, and the date and time the call took place.

3.     Realize You Can Negotiate

One of the vital points Susan emphasizes in the book is that patients should be aware that their bills aren’t necessarily set in stone. In fact, mistakes in medical coding are prevalent — whether inadvertent or not. Although a medical bill shouldn’t be ignored, it also shouldn’t be paid before you take a close look at it to make sure it’s correct.

In most instances, a high medical bill can be lowered by negotiating a reduction. Many patients may not know that they can also go through an appeals process if they aren’t satisfied with the answer they might get over the phone when they call the insurer. Significantly, in order to build a strong case for an appeal, it’s important to know what your plan covers.

How Systemedic Can Help with Your Medical Bill Dispute

If you’ve incurred a substantial medical bill, a medical bill dispute advocate can help. Systemedic has been providing effective advocacy for patients who have received excessive medical bills and hospital bills for over three decades. Systemedic knows how to negotiate even the most complicated bills efficiently and effectively. Offering a fee-based service for those looking to dispute their medical bills, Systemedic’s medical bill dispute advocates are skilled in navigating the insurance maze and will not take “no” for an answer. To get started with resolving your medical bill dispute, contact Systemedic for a consultation.

Learn More About the Book: Get What’s Yours for Health Care

Get What’s Yours for Health Care helps patients understand the basics of health insurance and gives them the tools they need to find the right plan for them. Covering a broad range of topics from the Affordable Care Act to employee health insurance plans and making healthcare choices, the book is a crucial guide for anyone covered by health insurance. Get What’s Yours for Health Care is available for purchase on Amazon. More information about the book can be found at www.getwhatsyours.org.

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