6 TIPS TO NEGOTIATE YOUR MEDICAL BILLS

By Darshini Sitharam  |  Updated: January 27, 2019

Situations where you feel so sick that you need to get into an emergency room is a feeling that is quite disturbing itself. Perhaps another situation that seems almost the same is when you are anxiously waiting for how much the medical bills will be after being treated. Sometimes you can to reduce your financial burden if you just know the right questions to ask.

1. Ask if you are eligible for any discounts

Most patients do not know that they are eligible to receive discounts via some payment methods (e.g. using a credit card from a specific bank) or through any charity program that the hospital participates in. Usually the hospital will not tell you about any available offers. So, you need to be proactive to ask for any discounts you deserve.

2. Know all the fees that will be associated with your procedure

Make sure you include all the fees associated with your procedure, not just the cost of surgery. For example, anesthesiology, radiologist, laboratory fees and so on. You should also list the doctors who went to consult you in your room. This is because each doctor has different consultation fee. Check your medical bill with the list you created. Perhaps you can detect any errors in the bill.

3. Learn to detect the common mistakes made in your bill

Sometimes there are unintentional mistakes and you need to know how to find them. Every procedure performed by the hospital has a kind of code that allows hospitals to finance insurance companies. Most patients do not know what the codes mean. Among the coding mistakes frequently found in hospital bills are:

Unbundling - The services that need to be billed together have been billed separately. For example, various health tests have been conducted and billed separately although all the tests are related to a single diagnosis.

The number of procedures billed more than the actual - You have been billed multiple times for the same procedure.

Codes do not match - When the treatment code in the bill does not match the diagnosis. In this situation, the insurer can deny your claim.

Upcoding - You are charged for a different treatment (more expensive) than the treatment received. For example, you are charged for branded medicines even though you are consuming generic drugs.

Balance Billing - A situation where there is a balance that you have to pay after the insurance company pays your medical bills even though your insurance policy states otherwise. There may be a problem with the automatic billing process.

4. Get to know some medical billing terms

Here are some frequently used terms you need to know:

Deductible - The minimum amount you need to pay to the hospital before your health insurance company starts paying for your medical expenses.

Co-pay - The amount of the prescribed price to be paid by the patient to the hospital before receiving some medical services.

Co-insurance - Similar to co-pay but the patient only has to pay just a percentage of the original cost to the hospital. The insurance company will pay the remaining amount after getting treatment.

In-network - Hospital/clinic covered by your insurance company.

Out-of-network - Hospital/clinic that is not covered by your insurance company.

5. Visit your hospital's billing department

Go to the office of your hospital's billing department if you spot any mistake in your medical bills or you have difficulties paying for it. Usually they already have some solutions in place to help their patients.

6. Call a consultant to help you

There are experts out there who can help you if you feel less knowledgeable about negotiating your own medical bills. Of course there is a fee charged for this service. So you need to really consider this option before contacting the experts.

In conclusion, being a knowledgeable patient is important to avoid mistakes during the process of paying your medical bills. Do not be afraid to ask any questions with the hospital about your bill. Negotiate calmly and clearly with the hospital. In this way, your negotiation process will be easier to manage.

~ Darshini Sitharam is an author, editor and digital strategist specializing in health and lifestyle content.

 


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