Nothing is more frustrating than receiving surprise medical bills, and this is especially upsetting when you believed your health insurance provider covered the procedures listed on the bill. You can get quality medical care and avoid high medical bills, and here are a few strategies to do it.
Understand the No Surprises Act
This law went into effect in 2022, and it’s designed to prevent people from receiving surprise medical bills. This is also known as balance billing, and it’s when a healthcare provider sends you a bill after your health insurance provider paid part of the bill for the services you received. The balance bill is the difference you pay after your insurance pays its share. The No Surprises Act makes this practice illegal. This is especially beneficial for patients who have to receive out-of-network emergency services. This law also covers the costs of treatment at in-network facilities.
Ask For Itemized Bill
Before you pay the surprise medical bill, request an itemized bill. As you review the bill, look for incorrect dates of doctors’ visits or procedures, duplicate charges, fees for services you never received, and services that your health insurance provider covers. In addition, request an explanation of benefits from your health insurance provider. It helps you compare the charges on the bill with what your insurance covers. If you see errors, dispute them immediately.
Inquire About Payment Options
If you need to receive medical care from an out-of-network provider, inquire about payment options beforehand to prevent surprise medical bills. Ask about any payment plans available and if any discounts exist to pay for your services. When you know your options, you can arrange for a flexible payment plan and reduce the stress of medical debt.
Stick to In-Network Providers
Save money and avoid surprise medical bills by getting your services from in-network providers. When you get services from out-of-network providers, your costs may be higher. If necessary, switch to a health insurance company that has the doctors and specialists who are the best fit for you.
Review Your Health Insurance Policy
It helps to review your health insurance policy because you want to know which procedures are covered and which ones aren’t. If you’re still unsure about certain procedures, call your health insurance company to get more clarification on the issue.
Learn the Different Medical Billing Codes
This may sound tedious and unnecessary, but it can keep you from receiving expensive medical bills. You have certain doctor’s visits and procedures that are generally free with insurance, such as mammograms and annual eye exams. Other additional services cost you extra money. These services come with certain billing codes, and if you know some of them, you’ll know what you’re being charged for. Some medical billing codes are:
99214: Outpatient visit ($261)
90837 Psychotherapy sessions ($443)
81002 Urinalysis ($20.00)
71046: Chest X-Ray ($139.00)
Inquire About Financial Assistance
Another option would be to ask about financial assistance. Contact the hospital’s billing department and ask what the requirements are to receive this assistance. This is especially a good idea if you received services from a nonprofit hospital. You may be able to get a flexible payment plan that suits your budget. Depending on the hospital, some or all of your costs could be waived.
Apply for Medicaid
Medicaid can protect you from surprise medical bills because when you apply for these benefits, you may receive them for medical expenses over the past three months or more, depending on your state’s laws. This saves you money while still getting the quality care you need.
Work With a Patient Advocate
Patient advocates can help you eliminate or reduce surprise medical bills. Choose someone skilled in medical billing and who can get the results that patients need. Patient advocates should also possess solid communication skills.
Avoid Unnecessary Procedures and Tests
Doctors often recommend certain procedures that they think will relieve your condition. However, those procedures may be unnecessary and possibly cause more problems. Research your condition and if you feel that your doctor’s suggestions aren’t needed, decline the procedures or medications.
Open a Health Savings Account
A health savings account is where you contribute and invest funds only for qualified medical expenses. HSAs are also tax-free, including your initial contributions, interest earned, and withdrawals. Only people with high-deductible health plans can open an HSA. You can also use this account to pay for medical bills in retirement.
Choose the Right Health Insurance Plan
This will help you avoid surprise medical bills because when you have the best plan possible, you won’t need to use out-of-network services to get your medical needs met. If you don’t want to deal with having to get referrals before seeing certain specialists, don’t get an HMO-based plan because they generally require referrals. Instead, choose a PPO-based healthcare plan. Write a list of your preferred doctors and specialists and find out if they will be a part of the plan you’re choosing.
You should also choose a plan that offers the benefits you’ll use the most. If you have children with special needs, then look for a plan that adequately covers various therapies and medications your children will need. Other vital benefits to consider are laboratory tests, mental health services, pediatric services, vision and dental benefits, and hospital stays.
Healthcare doesn’t need to break your budget. By using these effective strategies, you can have the medical care you need without the expensive bills.