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Posted on 17. October 2019

Preventing Surprise Medical Bills

By Abbie Cornett

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I save paying medical bills until I am in a really bad mood. I figure that's the perfect time to do it because dealing with insurance and billing offices sucks! If I pay them when I am in a good mood, it always ruins my day, so I figure I should pay them when I am already in a foul mood.

To be fair, like most people, I don't like paying bills, but I can honestly say it's usually a fairly simple process. I know what I have bought or what services I have used and how much it is going to cost. That is not the case for medical bills. I never know how much anything is going to cost until after I have received the service, and frequently, I have no idea who I owe money to.

As an example, I had to take one of my daughters to the emergency room about six months ago. I received a bill from the hospital and paid it. No big deal, right? Wrong! I received a bill months later marked final notice from a company I had never heard of. Apparently, not only do the emergency room doctors bill separately, but so does the lab.

To make a long story short, the hospital had given the lab the wrong address and insurance information, so I didn't receive the bill until it was ready to go to collections. You would think the office that sent me the bill would be happy I called to straighten it out. Nope! I got lectured on paying my bills on time. To add insult to injury, the person I was talking to didn't want to take the correct insurance information. She said: "It is too small for me to be bothered with refiling with your insurance. Can't you just pay it?" It was at that point the conversation went south.

For me, the worst part of the whole situation was realizing that even with all my years of experience with hospitals, doctor offices and insurance companies, I still almost got turned over to a collection agency for a bill that was covered by insurance. I wonder how many people with less experience have been forced to pay bills that should have been covered or have had their credit ruined by a surprise medical bill.

After I calmed down, I researched the situation and found it is way more common than I thought. In fact, several estimates suggest one of five inpatient emergency department visits may lead to surprise bills. Unlike my case, a surprise bill usually refers to a medical bill that a patient unexpectedly receives because he or she was treated by an out-of-network provider at an in-network facility.1 These out-of-network bills can cost patients thousands in unexpected out-of-pocket costs.

The problem has become so pervasive that policymakers at both the state and federal level are proposing legislation to address the issue. In the meantime, there are some steps you can take to help protect yourself. Aetna recommends the following six tips to avoid surprise medical bills:2

  1. Research your preventive care coverage and billing codes before your visit.
  2. Ask your doctor to use in-network labs for bloodwork, MRIs and other tests.
  3. Shop around for the best price on medical tests and procedures.
  4. Beware of "facility fees."
  5. Prep for emergencies by finding out about ambulance providers in your area.
  6. Know your rights around "balance billing."

While the above steps may help prevent a surprise bill, as a patient and patient advocate, I can guarantee you will still have fights ahead of you. So, take my advice, life is too short to waste a good day fighting!

 

References:

1.   Blumenthal, D. The Underlying Causes of Surprise Medical Bills. To The Point, April 26, 2019. Accessed at
www.commonwealthfund.org/blog/2019/underlying-causes-surprise-medical-bills.
2.   Fujimori, S. 6 Tips to Avoid Surprise Medical Bills. Aetna. Accessed at
www.aetna.com/health-guide/tips-to-avoid-surprise-medical-bills.html.

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