Unless you’re remarkably lucky, if you live long enough in the U.S., you’re eventually going to be hit with a medical bill so large it will make your jaw drop. Even if you’ve been lucky enough to avoid this nightmare yourself so far, you certainly know someone a medical bill horror story. Through all the shock and confusion you may wonder: Is there a right way to tackle a medical bill filled with unexpected charges?
The first thing to remember is that there is a lot of erroneous billing going on out there. The next time you get a medical bill, it’s worth making a phone call (or two, or one hundred...) to find out if you actually have to pay it—there’s a chance it was billed to you in error. Whether human error, technical glitch, or deliberate scam, the bottom line is that you should understand exactly what you’re paying for before you cough up a cent.
Sadly, our healthcare system makes patients responsible for ensuring they’re staying in-network, double-checking bills for errors, and advocating for their own low-cost care. To get you started, here are three questions you should ask before you pay an unfair medical bill.
Can I see an itemized bill?
A medical bill can be a mess of confusing codes and intentionally vague charges. Always ask to receive an itemized bill to make sure you’re not being overcharged for services you may not have even received. Despite hype about this hack you may see online, an itemized bill won’t necessarily slash your costs in half. One may, however, give you the leverage to argue against fraudulent charges or human mistakes on your bill.
In reviewing the itemized bill, ask yourself: Do I recognize all the charges? Are the dates and providers correct? To determine this, you’ll want to compare the bill with the explanation of benefits (EOB) you should have received from your insurance. On that note...
Has my insurance been billed properly?
If a bill is higher than expected, confirm your insurer has been billed correctly. When you compare your itemized statement to the explanation of benefits provided by your insurer, you’ll be able to see whether they were billed for the same services. What you’re looking for is a charge on your statement that does not appear on the EOB, so that you contact your provider to request your insurer be billed for that service, too.
How much will this cost?
Your best defense against an unexpectedly high medical bills? Be proactive before the bill arrives. While you’re still at the hospital, doctor’s office, or pharmacy, ask your cost questions ahead of time: How much will this cost? Are there low-cost alternatives? Do I absolutely need this procedure/test/treatment?
Asking these sorts of questions this will help you avoid painful and potentially futile negotiations down the line. It’s bleak, but this is also our current reality. So at the very least, make sure you’ve asked all the questions above before you wind up paying an unfair bill.