News 2/5/2021

LIfehacker: You Might Not Have to Pay That Medical Bill

The next time you get a medical bill in the mail, it’s worth the phone call to find out if you actually have to pay it, or if it was billed to you in error. When it comes to medical bills, mistakes are more common than you think.

Unexpected medical bills are both pervasive and expensive: 61 percent of American adults have received at least one bill they thought would be covered by insurance, totaling an average cost of $520, according to a recent Value Penguin survey. Some of this includes balance billing, which is when you receive a surprise bill for the amount not covered by your insurance company by an out-of-network provider, which is a practice allowed in most states.

However, while estimates vary, roughly 30 – 80 percent of the medical claims contain a mistake, including wrongly denied claims or surprise fees. That means you’ll want to examine each medical bill carefully before paying for it.

What to do about a surprise bill

Fortunately, help is on its way—Congress recently passed the No Surprises Act, which provides new federal consumer protections against surprise medical bills (the bill takes effect on January 1, 2022). The law requires private health plans to cover surprise medical bills for emergency services in which you have a limited opportunity to make a choice for a provider, like air ambulance services, as well as out of network provider bills for services rendered at in-network hospitals and facilities.

In the meantime, some states already have such protections in place, with programs that can advocate on your behalf. If you don’t have access to a program like that, call the office that billed you and ask for a detailed breakdown of the charges. Then, compare the list against your insurer’s explanation of benefits.

“Call the billing office and ask them to explain what each of the charges are. If an office manager can’t answer, ask to speak to a nurse or technician on staff. It really is the best line of defense,” recommends Bridget Lipezker, senior vice president of advocacy and transparency at DirectPath, in an interview with CNBC. This can be a drawn-out and frustrating process, but it could end up saving you potentially hundreds of dollars.

If your bills stem from a larger medical treatment (for example, a hospital stay), collect all of the paperwork you have and see if your employer offers advocacy services that can help you make sense of all of it (go to human resources if you’re unsure if it’s offered).

Read the article here.

(Alicia Adamczyk is a writer for CNBC Make It  and Mike Winters is a contributor to Lifehacker)

Retailer Uses DirectPath’s Transparency Services to Empower Health Enthusiasts to Make Informed Health Care Decisions
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