We have all seen it. Your client has outstanding big medical bills and the topic weaves its way into the conversation. So how do you help? Here’s a quick overview of advice that will point your client in the right direction.
Tip #1 – Learn how to spot billing errors without any knowledge of complex coding.
According to an article in the Wall Street Journal, “How to Fight a Bogus Bill,” up to eight in 10 medical bills contain errors because of coding mistakes! You can spot these errors by requesting an itemized bill from your health care provider and then going over each line of the bill with your doctor or clinic. You may be surprised by what you find. Common issues include:
- Upcoding – This is a medical bill that is improperly charged as a more intense treatment. This is most common when a name-brand medication is billed for a generic medication, pinning you with a more expensive bill.
- Unbundling – This is where services that should be packaged together are split and billed apart. This leads to increased costs. This is common when multiple medical tests are ordered, but all relate to one condition.
- Balance Billing – This is the leftover balance after the insurance company pays. All of the charges may be covered under your policy, so you may not actually owe this leftover amount. Uncommon, but still happens with automated billing processes.
- Duplicate Billing – This is more common than you would expect. This is where you are billed multiple times for the same procedure. This may happen when a nurse and doctor both input a bill into the system without checking with each other.
- Mismatched Coding – This is where the treatment code does not match the diagnosis. In this situation, the insurance company then denies the claim. The bill is sent back to the provider and will either be corrected or sent down to the patient with the error.
Tip #2 – Priceshop your health insurance and your treatments before you go in for health care.
For starters, does your health care plan really fit your needs? Check health insurance quotes to confirm you have the best health insurance for your medical needs. Then priceshop your health care BEFORE you go in for treatment. There is an online health care blue book (healthcarebluebook.com) just like the automotive blue book for buying cars. Make use of this to determine what prices are reasonable for your location and type of care.
Tip #3 – Learn to negotiate.
State that you are willing to pay something, but unable to pay the full amount. These words trigger the health care provider to work with you to figure out an arrangement. There are often financial assistance programs available, but you have to prod and dig to find them. Do not be afraid to make a discounted offer to close the account. A reasonable offer is generally around 60 percent of the original medical bill. Why 60 percent? When your medical bill goes to collections, the health care provider has to pay the collection company 20-30 percent of the amount collected. Also, you will have better success if you are able to pay cash up front, rather than over a period of time on a payment plan. For example, if you can offer $600 now for a $1,000 bill, this would be a great offer for the health care provider. This is by no means easy, but I am confident that your clients can do it without the help on an attorney.