Take these steps to make sure you’re not paying the doctor or hospital more than you owe.
Up to 80 percent of medical bills contain at least one error. So, if you think you’ve overpaid at least once or twice on a doctor or hospital bill, chances are you’re probably right.
The good news is that you can avoid paying too much on medical bills by taking certain steps to make sure you’re covered for certain medical services, choosing health care providers wisely and knowing how to read the explanation of benefits (EOB) your health insurance company sends after receiving the claim from a health care provider.
Before you take out your credit card to pay a medical bill you want out of your life, here are four tips for making sure you don’t pay more than you owe.
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1. Review health insurance coverage
When you know what your health insurance covers, you can choose services accordingly so that claims are less likely to be denied by your health insurance provider. Reviewing your health plan can help you avoid surprise medical bills, unexpected copays or out-of-pocket expenses and expensive prescriptions for medications that aren’t covered by your plan.
If you renewed last year’s health plan, don’t assume that all overage remains the same. Health plans can change from year-to-year, so look over your health insurance policy online or in the handbook your insurance carrier sent in the mail before scheduling medical care.
2. Use in-network providers
Health insurance plans typically have a network of hospitals, doctors and other health care providers included in the health insurance carrier’s network. When you use your insurance carrier’s in-network providers, you’ll typically receive negotiated rates or partial or full coverage of the service, depending on your health plan.
On the other hand, when you use an out-of-network provider, health care costs and services received aren’t usually covered. That means you’ll pay full price for all health care services received from an out-of-network provider. To save money, stick with in-network providers if possible. Find your health plan’s in-network health care providers by login into your health insurance account online.
3. Check the explanation of benefits (EOB)
When your health care provider sends a claim to your health insurance, the insurance company will send you what’s known as an explanation of benefits (EOB). Even though the EOB may look like a bill, it’s not. Instead, the EOB shows the service description, how much your health care provider bills and the medical billing code. The EOB also shows the amount your insurance company reimburses and the amount you owe the doctor or hospital under “patient responsibility.”
If a health care provider sends a bill for an amount owed before you receive the EOB from your health insurance provider, hold off on payment until you receive the EOB so you can compare the amount billed to the patient responsibility amount, which is typically less.
4. Request an itemized bill
If a health care provider sends you a bill with only a lump sum and minimal information other than the date of service and the amount owed, ask for an itemized bill. That way, you’ll know the cost of each service for which you’re being billed and the billing code so you can compare the itemized bill to the EOB.
When reviewing the itemized bill, also watch for services billed that you may not have received. For example, if your doctor ordered a test and then canceled the order, you may have gotten accidentally charged for services you didn’t receive.
What can I do if I overpaid?
When a doctor’s office or hospital bills for more than the patient responsibility amount on your EOB, it’s probably an unintentional mistake caused by sending the bill before receiving the amount owed under your health insurance plan.
If you’ve already paid the doctor or hospital bill and see on the EOB that you actually owed a lower amount, contact your health care provider’s billing department and ask for a refund. The billing office should process the refund by crediting your credit card or bank account.
Published by Debt.com, LLC