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Home > Blog > What to Do When Your Insurance & Hospital Do Battle
FRIDAY, AUGUST 2, 2013

What to Do When Your Insurance & Hospital Do Battle

When you’re in recovery from a hospital visit — whether it’s a major surgery, a visit to the emergency room or just a routine procedure — the last thing you want to worry about is paying your medical bills. Although the doctors may have stitched you up, sometimes they don’t quite stick to procedure when it comes to filing your bills with your insurance company.

Here’s how to avoid a misfiled medical bill or one that contains errors.

Pay Attention

As with any other billing statements, be sure to read medical bills line-by-line to see what you’re paying for. Sarah O’Leary, CEO of ExHale Healthcare Advocates in Los Angeles, says that experts in the field have estimated that up to 40% of medical bills contain errors. Staying in the habit of diligently reading your bills ensures that you’ll be aware when an incorrect bill comes through.

It Doesn’t Hurt to Check

Even if you’re not sure that a charge is incorrect, it can never hurt to ask. “One of the biggest problems we have is that we trust our doctor, our hospital, and we give that trust away to our insurance companies,” says O’Leary. “We assume that they’re acting 100% in our best interests.” But that isn’t always the case. Even something as simple as an incorrect medical bill code or computer model can lead to mistakes, and just because you’ve already received treatment doesn’t mean you’re liable. “Everything can be negotiated,” she says. “Even if you’ve already received the health benefit, had tests run or an operation, and you have the bills in front of you — those bills can be negotiated down significantly.”

State Your Case

Once you’ve found that you’ve been incorrectly billed, inform both your healthcare provider and insurance company that you’re not responsible for the charge. If the hospital submitted the paperwork on time, ask that they provide proof to your insurance company. If they didn’t file it appropriately, you’re not at fault and be sure they know you’re not liable for the charges. In either case, open a dialogue with both institutions, because whichever company is in the wrong is responsible for the bill.

Persistence Is Key

In medical billing, perseverance pays off. “The worst thing that can happen is you ignore them,” says O’Leary. “Don’t ignore it. Tackle it head on. Start a paper trail in the insurance company and the health care provider and they’ll be less likely to pass it on to a bill collector because it’s an open case.” As with any disputes, being vigilant and diligent in your communications is the key to winning your case.

Read More: Source

Posted 6:43 PM

Tags: hospital, health, medical, insurance, bill, claim
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