How To Protect Yourself From Costly Medical Bill Mistakes

We are all grateful to experience the greatest medical care in the world, but no one can quite prepare for costly medical bill mistakes that may come along with quality care. According to NBC news, statistics show that over $68 billion of health care spending is erroneously charged.

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On many occasions these are common errors like duplicate charges, inflated services rendered or incorrect insurance information, but regardless, millions of Americans are overpaying for the health care they receive. Mistakes happen and that could possibly cost the patient thousands of dollars being added to their final bill.

NBC's Ben Popken offers sound advice on what he considers overbilling-itis by health care providers. His 5 tips are:

  • Always price check before your surgery. It is a good idea to confirm the billing codes the provider will be submitting from the procedure and check with the insurance company to see how much of the care will be covered.
  • Get a detailed receipt from the health care provider and review it line for line ensuring codes and procedures were entered correctly and all prescriptions administered were delivered.
  • Call your provider and inquire about items not adding up and ask them to resubmit the bill removing coding error or erroneous items.
  • If you end up being in a billing tug-of-war, you may have to draft a dispute letter. The FTC has a draft letter to assist you in disputing charges.
  • Get help from a pro. You can also hire a medical bill advocate through Medical Advocates of America billadvocates.com who will help you reduce your bill, either for an hourly fee of $50-$175 or on a commission basis.

According to Andrew Fitch, it is good practice to view each medical bill with skepticism to ensure you are always paying the right amount. It is very wise to pull your explanation of benefits from your insurance provider plan and compare the benefits with the charges incurred very carefully.

The EOB should provide details such as the type of service received, the date of service, the amount your health care provider billed your insurance company, the total amount that was not covered and the total patient cost.

Additionally, Fitch highlights 3 other errors to look out for:

  • Canceled tests or procedures. Sometimes patients get charged for procedures that were scheduled, but canceled.
  • Unbundling of charges. This refers to the separation of charges that should have been billed under the same procedure code. This type of mistake can be tricky to identify unless you're a certified medical bill coder, but you can reference the National Correct Coding
  • http://wpsmedicare.com/j5macpartb/resources/new_providers/nationalcci.shtml by the Centers for Medicare and Medicaid (CMS) if you suspect a mistake on your bill.
  • Operating Room and Anethesia Time. If you underwent surgery, check your medical records for operating room or antethesia. These procedcures are typically billed in 15 minute increments and can get out of hand quickly if there are mistakes.

According to US News, there is a Medical debt problem in America with 1 in 5 Americans being contacted by collectors about their medical debt. In the report, Lacie Glover points out that medical bills are negotiable with the hospital and insurance providers.

Like the other experts, she believes it is crucial to:

  • Recognize you need help. Time is precious and the stakes are high, Not everyone has the energy to fight a large bill for an extended hospital stay.
  • Keep good records. When talking with someone about your bill, always get their name, location and call reference number.
  • Do not procrastinate. Hospitals are quick to send bills to collections. It is much easier to negotiate a discount prior to bills being sent to collections.
  • Know your stuff. Being prepared with your insurance information and fair pricing for charges gives you a leg up on other consumers when it comes to negotiating medical bills.
  • Consider all payment options. If you can't pay the bill, ask about payment plans and financial assistance. Most hospitals offer assistance to lower income families.

As a consumer, it is imperative to follow these tips that the experts offer to prevent being hit or overwhelmed with exorbitant medical bills. To be on the safe side, always review your bill carefully and collect all of the documents necessary and put forth your best compelling argument. Pat Palmer, Founder of Medical Recovery Services, an organization that assists patients in lowering their medical bills by identifying and correcting errors encourages consumers to look out for the basic mistakes and you could potentially save yourself thousands of dollars.

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