How to deal with surprise medical expenses | Reed Law Firm, P.A.

How to deal with surprise medical expenses

On Behalf of | Apr 18, 2019 | Medical Debt |

There's a reason why the news is constantly pumping out story after story about people struggling to deal with their medical bills. It's because health care expenses can eat up a serious chunk of your budget, and surprise medical expenses can be absolutely crippling.

You hear about stories like the woman who got a bill for $4,727 for an appendectomy at an in-network hospital, and you think, "I hope that never happens to me." But it could. Even if a hospital is in your insurance network, a surgeon might not be. Or the doctor could order a procedure that your insurance doesn't cover. These unexpected medical bills can be horrific. One man from Texas recovered from a heart attack only to be slapped with a bill of nearly $109 thousand.

When your medical bills can potentially total over $100 thousand - despite the fact you have insurance - it's easy to understand why 66.5% of all people filing for bankruptcy cite overwhelming medical expenses. But there are some ways you can protect yourself.

Check that your providers and procedures are all covered

Unless you're in the middle of a life-threatening situation, you want to make sure that your insurance covers all providers and procedures that will be part of your treatment. This means your doctor, anesthesiologist, and radiologist, as well as the hospital or clinic and all the tests or treatments you have scheduled. Even if one of these is covered, there's no guarantee they're all covered, so you want to check on all of them.

Review your bill

If your bill seems larger than it should be, maybe it is. Double-check to make sure your provider billed you for the correct services and at the right rates. You can call the provider to get a line-item bill and have them explain any arcane codes. You can also research most medical codes on Google.

Watch for "balance billing"

Balance billing is the process by which an out-of-network provider bills you directly for the difference between what your insurance paid and the full cost of your procedure. And since they're billing as "out of network," they're going to charge more.

Negotiate your bill

Medical bills can be negotiated. Fees and prices are negotiated all the time within the healthcare industry, and you can ask your insurance company to help you out. Ask them to explain the charges and see if they can negotiate any of them with your providers to have them billed at a lower rate.

File an appeal to your insurance or patient advocate

Especially if you find any errors in the billing, you may want to appeal your bill. Your insurance can push back against any errors the provider made with the billing. A patient advocate may be able to help you find some relief in the form of a discount.

Get legal representation

The sad fact is that sometimes even having medical insurance isn't enough to keep you from getting swallowed up by medical debt. But if this ever happens to you, it's important to remember that you have options and you are not alone.

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