How To Avoid Surprise Medical Bills

By Subodh / September 20, 2014

Nothing can be more unpleasant than receiving a large medical bill that catches you by surprise. Have you ever thought about why you have had to pay a large sum of money after a hospital stay or a visit to a doctor and what exactly you paid for? Well, you are not the only one. The good news is that there are many ways to avoid unexpected medical bills. All you need is to take out a little time to understand why you are spending such a large amount of money on medical expenses.

Tips on How To Avoid Surprise Medical Bills

Experts say that as a patient, you can always find ways to protect yourself from huge medical bills. It can be challenging but it is worth a try. Here are some of the ways to avoid unexpectedly high medical bills:

How To Avoid Surprise Medical Bills

1. Know Your Health Insurance

It is important for you to have a good understanding about the type of health insurance you have. Take the time to find out the rules and features of cost-sharing, etc. of the health care plan that you have. This will clear things up aboutwhy and what you are paying for. You should ask important questions which include:

  • What is the amount of the deductible?
  • Are there out-of-pocket costs involved?
  • What are these costs?
  • Do certain procedures and tests require approval in advance?
  • Does your plan prevent you from going out of network?

2. Stay Within Your Network

If possible, it is always best to stay in your network. If your plan provides payment for out-of-network medical care, the agreed amount that is set for payment is usually about 60 to 70 per cent. However, you should not be misled by this number as the coverage is a percentage of a bill amount that has been pre-determined and not a percentage of the cost of the out-of-network care. Normally, the coverage is much lower than the out-of-network provider’s bill so you will still need to pay a lot.

3. Conduct A Network Price Comparison

Nowadays, you can find out almost everything you need to know about medical insurance and the plans available on the Internet. This includes the prices of different plans from different networks. You should compare these prices so that you have all the necessary information about the cost of different services and procedures. If the information is not available online, contact your provider and ask for a cost estimate. You will find it immensely helpful, especially when major procedures are involved.

hospital bill

4. Pay After Receiving All Bills

Your medical bill may arrive from a doctor’s office or hospital and you may be startled at the amount you need to pay. Nonetheless, many people make their payments almost immediately without asking too many questions. You should never make this mistake. Experts say that you should wait for your provider’s EOB (Explanation of Benefit) bill before you pay the bill. The EOB will have a list of everything that you are responsible for.

5. Fight Bills From Out-Of-Network Care

A large number of people get a huge medical bill from a doctor who is not in their network after they go through a procedure or a visit to the ER in a network hospital. You should know that the hospital that you went to will most probably not know which plan the doctor has a contract with but you will definitely be expected to pay the bill. In this case, experts say that you can fight the bill and make an attempt to get the bill reduced to a more reasonable amount. Here are a few ways to do this:

  • Visit the doctor and ask for a reduction in the bill.
  • If he refuses, you should approach the patient advocate of the hospital.
  • You can also complain to your insurance provider, the insurance department in your state or the insurance consumer advocate in your state.

With proper information and a readiness to challenge any unexpectedly high medical bill, you can avoid making high payments. Thorough research and patience can go a long way in helping you avoid surprise medical bills. Keep yourself protected from medical expenses that can have an adverse effect on your life at all times by arming yourself with information.