How to Dispute and Pay for Large Medical Bills

If you’re looking at astronomical medical bills due to the coronavirus pandemic or another health emergency, you might think there’s no choice but to pay thousands of dollars for your treatment. This may not always be the case. Here’s some advice on how to bring down the numbers on your medical bills and tips on how to cover the remaining costs.

Step 1: Review your bill(s).

Typically, you’ll receive an Explanation of Benefits (EOB) from your insurance company along with the actual bill, which tells you how much you’re responsible for paying. It’s important to hold onto both of these documents and to review them carefully.

The EOB is a document provided by your insurance company explaining your insurance benefits as it pertains to a bill. It will usually include the following information:

  • Amount Billed by Provider (this refers to the amount the doctor or hospital charged)
  • Plan Discounts (this refers to a discount negotiated by your insurance company)
  • Amount paid by insurance company
  • Amount you owe the provider

Most EOBs will also include information about your deductible, co-pay and co-insurance. If a procedure or treatment is not covered, the EOB should include a short explanation about why it’s not covered. If your statement includes charges for COVID-19 testing or related expenses, like co-payments and deductibles, your insurance should be covering the entire amount, as per the Families First Coronavirus Response Act.

Review your bills carefully and make sure the EOB and the medical bill correspond with each other. If there is a discrepancy between the two documents, it may be a billing error. If you suspect an error, you may want to ask for itemized bills. This will provide you with a detailed breakdown of all costs charged to you for services and/or inpatient stays.

If you’re being billed for a hospital stay, review the charges carefully to be sure you’re not getting billed for a treatment you haven’t actually received.

Step 2: Review your insurance coverage.

It’s a good idea to familiarize yourself with your health insurance policy before disputing any charges. Most health insurance providers will present their members with a detailed manual that outlines exactly which treatments and charges are covered and which are not. Here, you can refer back to the EOB to see if the insurance paid for all the procedures it claims to cover.

Step 3: Dispute any errors.

If your insurance billed you incorrectly or did not cover a procedure or treatment that is covered under your plan, call a company representative to ask about the charge. Be sure to have your bill in front of you when you make the call, note the time of your call, the contents of the conversation, and the name of the representative you speak to in case you need it for future reference.

If the error is with your doctor’s office, ask to speak to an office billing representative and explain your position. Here too, keep a record of the conversation for future reference. Be prepared to make multiple phone calls until you reach a party who can make the change. It’s also a good idea to follow up with a written request to challenge any charges in question.

Step 4: Negotiate the remaining bill.

If the bill is unimaginably high after all the errors were corrected, you still have options. Consider negotiating with the billing department at your doctor’s practice for a lower price on the treatments rendered. You may want to do this in person, and most practices will allow you to schedule an appointment with a representative of the billing office. Bring all your bills and other supportive documents, such as receipts from the pharmacy and information from your insurance provider. If you believe a charge for a procedure has been unreasonably inflated, it’s a good idea to research the going rate of coverage through sites like HealthcareBluebook.com and My Healthcare Cost Estimator first.

At the meeting, explain that you are having difficulty with your bill and that you’re looking for a way to lower the costs. Here are some open-ended questions to guide your negotiations:

  • What discounts do you offer for financial hardship?
  • Which of these fees can be waived?
  • Many hospitals have charity relief plans for patients having difficulty meeting their payments, can you tell me about yours?
  • Can you charge me what Medicare would pay for this service?
  • Can you lower some charges if I pay this off sooner?

Step 5: Create a payment plan or seek funding.

Once you have your final bill amount, you’ll need to choose to pay it now or work on creating a payment plan to make it more manageable.

If you’d rather not have a huge bill hanging over your head for awhile, or your doctor’s office insists on immediate payment – consider some other options. One way to help pay your bill is by applying for a personal loan from First Financial.* This method will provide you with the funds you need to pay your bill, along with a payback plan offering flexible terms and manageable monthly payments. Another option would be using your emergency savings fund, if it will help cover any expenses.

Step 6: Going forward.

To avoid an unexpectedly large medical bill in the future, you may want to consider switching your insurance plan to one that provides more robust coverage and less expensive co-pays and deductibles – if at all possible. Your premiums will likely increase, but the change may be financially worthwhile if you know you may have ongoing medical expenses.

Another long-term option to consider is setting up a Health Savings Account (HSA). The funds you contribute to this account are tax-deductible, grow tax-free and can be withdrawn to cover qualified medical expenses.

If you’d like to talk to us about personal or consolidation loan options, contact us! We’re here for you.

*APR = Annual Percentage Rate. Rates are subject to change. Maximum loan is $25K and maximum term is 60 months. Not all applicants qualify, subject to credit approval. A First Financial membership is required to obtain a personal loan, and is open to anyone who lives, works, worships, volunteers or attends school in Monmouth or Ocean Counties. A $5 deposit in a base savings account is required for credit union membership prior to opening any other account/loan. See credit union for details. 

Article Source: CUContent.com

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