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From: http://money.usnews.com/money/blogs/my-money/2014/09/08/6-questions-you-should-ask-before-paying-any-medical-bill
1. Is this statement comprehensive?
Paying any bill without an itemized listing of services is a big mistake because you simply don’t know what you’re paying for. You’re entitled to this itemized medical bill, so calling the billing department and requesting a full, detailed statement should work.
2. Are all identifiers correct?
“Be sure the medical bill includes the correct medical insurer address, policy number and group number.” If any one of these identifiers is incorrect or incomplete, it could cause a complete claim rejection by your insurer.
3. Did I receive all of these services?
Whether by honest mistake or illegal billing practices, items can show up on your bill erroneously. Sometimes, a doctor orders a test and cancels it before it’s done.Keep an eye out for duplicates, too. Believe it or not, in some medical billing programs, duplicating a charge is as easy as accidentally hitting the return button an extra time.
To guard against this practice in the future, “it is best to keep track of the procedures that you experienced, and check the charges against your bills.”
4. What else looks fishy?
Incorrect identifiers and extra charges aren’t the only errors medical billing employees make. When the description of the billing item is vague, or you’re not sure from the description if the CPT code is correct, you can look up the code on the American Medical Association’s website. Other common errors include:
Once you’ve gone through above 5 steps and can't find anything wrong with your bill, it's time to go ahead and pay.
On the other hand, you may have a series of notes and concerns about the accuracy or fairness of the bill or insurance claim. If this is the case, you have a few more steps to take care of, but the upside to that is they will most likely save you money.
First, call the hospital’s billing department and relay your concerns. Your best bet is scheduling a face-to-face appointment with a billing representative.
If one of your concerns is an unreasonable fee for a particular service, prepare by using a price comparison tool online ahead of time so you can suggest a reasonable charge. During this appointment you can go over the errors you’ve found and discuss fair pricing. You can also explain what you can actually afford to pay in hopes that some charges will be reduced.
After this appointment, the claim should be resubmitted to your insurance company. If there are any services they didn’t cover and should have, you can contest their decision as outlined in your insurance policy – it’s required by law to be plain and clear. If all of this seems too much to handle, consider hiring a medical billing advocate to help you navigate the medical billing world.
Paying any bill without an itemized listing of services is a big mistake because you simply don’t know what you’re paying for. You’re entitled to this itemized medical bill, so calling the billing department and requesting a full, detailed statement should work.
2. Are all identifiers correct?
“Be sure the medical bill includes the correct medical insurer address, policy number and group number.” If any one of these identifiers is incorrect or incomplete, it could cause a complete claim rejection by your insurer.
3. Did I receive all of these services?
Whether by honest mistake or illegal billing practices, items can show up on your bill erroneously. Sometimes, a doctor orders a test and cancels it before it’s done.Keep an eye out for duplicates, too. Believe it or not, in some medical billing programs, duplicating a charge is as easy as accidentally hitting the return button an extra time.
To guard against this practice in the future, “it is best to keep track of the procedures that you experienced, and check the charges against your bills.”
4. What else looks fishy?
Incorrect identifiers and extra charges aren’t the only errors medical billing employees make. When the description of the billing item is vague, or you’re not sure from the description if the CPT code is correct, you can look up the code on the American Medical Association’s website. Other common errors include:
- Billing for a private room when you were in a shared room.
- - Upcoding, or charging you for a higher level of service than you received, especially if emergency services were used.
- - Operating room overcharges. Anesthesia records should have start and stop times, and operating rooms usually charge by the minute, so you can compare the times of each to ensure your OR fees aren’t too high.
- - Unbundling errors occur when you are billed for a group of services under one code and again separately using a different code.
- Many hospitals and medical centers routinely charge exorbitant fees for supplies such as gowns and gloves, or toiletries. A $1,000 toothbrush and $300 for hospital gowns and gloves are not unheard of. Just because a charge like that is on your bill doesn’t mean you have to pay the full cost. Medical bills are negotiable.
- 5. Where is my EOB?
- You can check the EOB against the bill and your insurance policy at the same time to make sure everything was covered that should have been.
Once you’ve gone through above 5 steps and can't find anything wrong with your bill, it's time to go ahead and pay.
On the other hand, you may have a series of notes and concerns about the accuracy or fairness of the bill or insurance claim. If this is the case, you have a few more steps to take care of, but the upside to that is they will most likely save you money.
First, call the hospital’s billing department and relay your concerns. Your best bet is scheduling a face-to-face appointment with a billing representative.
If one of your concerns is an unreasonable fee for a particular service, prepare by using a price comparison tool online ahead of time so you can suggest a reasonable charge. During this appointment you can go over the errors you’ve found and discuss fair pricing. You can also explain what you can actually afford to pay in hopes that some charges will be reduced.
After this appointment, the claim should be resubmitted to your insurance company. If there are any services they didn’t cover and should have, you can contest their decision as outlined in your insurance policy – it’s required by law to be plain and clear. If all of this seems too much to handle, consider hiring a medical billing advocate to help you navigate the medical billing world.
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