Four Solutions to Medical Bill Problems

There’s something a little scary about receiving a medical bill or a letter from your insurance company claiming you owe money. These tiny sheets of paper can send many of us into panic mode.

When you receive a medical bill or explanation of benefits (EOB) from your insurance provider, do you immediately whip out your checkbook and mail your payment? Are you terrified you’ll be turned over to a collection agency if you don’t pay the bill directly?

Not so fast! Before you cough up the cash for that medical bill or EOB, doing a little homework is essential. Don’t simply assume that you have to pay the bill. First of all, it could be a mistake. Secondly, the doctor’s office or hospital will not immediately send your account to collections. And most importantly, if you pay the bill only to realize later that your insurance covered it, it can be tough to get a refund.

So, put away that checkbook and read on to learn the solutions to four common medical bill problems:

Common Problem #1:  You receive a bill for a covered service.

Let your medical provider send you a bill for a service or procedure that your insurance has always covered. Please don’t assume your insurance provider has simply changed their coverage. More often than not, the insurance company hasn’t had a chance to pay the bill.

If you receive a bill for a commonly covered service, let it sit for 30 days. This should give your insurance provider plenty of time to pay off the bill. However, if you receive another statement from the medical provider, call your insurance company to find out what’s happening. You should also contact the medical provider to inform them that you’re working with the insurance company to ensure they pay.

Common Problem #2: You see the word “DENIED.”

You go to the doctor or dentist for a standard service that your insurance company usually covers. However, a few weeks later, you received a claim stamped with the wrong word, “DENIED,” in bright red letters.

Don’t freak out because it’s probably just a mistake. The medical provider may have incorrectly coded the treatment. Call your insurance company and ensure the claim matches the service you received. If not, let them know what happened and find the proper code for your treatment. You may need to follow up with the medical provider, as well.

Common Problem #3: You have a messy pile of EOBs and bills and no idea what you owe.

If you have a mess of EOBs and medical bills, it can be challenging to figure out what goes with what and how much you need to pay. That’s why it’s essential to keep all of your medical records as organized as possible. A little bit of organization could save you a lot of time, money, and frustration down the road.

When you receive a bill from your medical provider, staple it to the coordinating EOB from your insurance company. Please keep all your accounts in a folder so you can easily and quickly access them. If you call your insurance company or medical provider to discuss a particular claim, write notes on the EOB or bill to keep track of who you talked to and what you discussed.

Common Problem #4: Only a portion of your claim was paid.

Let’s say you received a standard medical treatment typically covered in full by your insurer. But a few weeks later, you discover your insurance company covered only a portion of the claim. It could be a slip-up on the insurer’s end, or the medical provider could have coded the treatment incorrectly. But often, this happens when you go to an out-of-network provider.

You’ll probably have to pay this claim if that’s the case. When you go to a provider not part of your insurer’s network, you often have to pay more out of pocket. However, if you receive this kind of bill and you’re sure you saw a network provider, give your insurance company a call. It could simply be a mistake.

Of course, these are just a handful of medical billing problems, and patients deal with these and countless other medical billing issues daily. So, the next time you receive a bill or EOB in the mail, don’t panic. Call your insurance company and the medical provider to discuss your concerns when in doubt.