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Once you’ve gotten a medical bill, it’s important to make sure it’s accurate.
Studies have shown that 40-80% of medical bills have mistakes!
Reviewing Your Medical Bills
What to Look For When Reviewing Your Medical Bills:
Mistakes
Compare any bills that you get to the Explanation of Benefits (EOB) that you get from your health insurance company. The charges should match.
Small errors, like your health provider entering a wrong number or code, can make a big difference in your bill.
You can prevent these mistakes by asking for an itemized list of charges, requesting a copy of your medical records and pharmacy ledgers, and checking that everything matches up.
If something seems off, ask your provider to clarify.
Charges You Can Challenge
You might be able to challenge certain charges. Watch out for:
Procedures that were ordered and then canceled
Medication ordered for you, but never given to you
Unneeded extended operating room times
Hospital errors (e.g. lab results were lost so the test had to be redone)
Hospital delays (e.g, an extra night’s stay in the hospital because of an unavailable surgical suite)
Your Deductible or Out-of-Pocket Maximum
Your provider may not be aware that you have met your annual deductible or out-of-pocket maximum, which could lower the amount of your bill.
Reach out to your providers and your insurance company to ask for support! Don’t be afraid to ask them to explain or clarify codes or descriptions of the services you received, and why they paid the amount that they did – you don’t want to be charged for services you didn’t receive.
Managing Your Medical BillsKeeping your medical bills and other documents organized and accessible can save you time and moneyGet Organized
There are many tools available to help you keep track of your medical bills, EOBs and medical records. Use whichever tool you find most helpful to stay organized, whether it’s a box with folders or a 3-ring binder.
Make sure to keep track of:
Communications that you have with your health care providers and health insurance company.
All medical and dental costs, including meals, lodging, and travel expenses related to medical care. These expenses may be tax deductible or possibly paid for through a flexible spending account (FSA), health savings account (HSA), or health reimbursement arrangement (HRA).
Your Deductible or Out-of-Pocket Maximum
Your provider may not be aware that you have met your annual deductible or out-of-pocket maximum, which could lower the amount of your bill.
When you are overwhelmed with bills, family members and friends can help with tasks like opening the mail, matching EOBs to bills from your provider, and putting payment due dates on your calendar.
These tasks might seem simple but having help can significantly reduce your stress levels and your family and friends may have had similar experiences that they can share with you.
Reach Out to a Case Manager
Some insurance companies provide their customers with case managers to help them navigate medical care, health insurance policies, and bills.
If your insurance company offers case managers, make sure to ask for the same case manager each time you reach out to your insurance company - it helps avoid re-explaining your situation.
While case managers may be helpful, they work for the insurance company, and it is equally important to keep track of every conversation with them, including who you talked to, when, and what you discussed.
Hire a Professional Bill Reviewer
A professional bill reviewer or medical claims organization can help you with things like doing a comprehensive review of your medical bills to make sure they are accurate and checking diagnosis codes for upcharges.
They may also be able to help negotiate payment plans with your providers.
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