Medical Bills and Arbitrary Costs: Add These Strategies to Your Toolkit

Media, consumer advocates and others talk a lot about how many of us are facing absurdly high costs for medical treatments. We know that these charges range significantly from location to location and that many times you may be hit with the majority of the balance. Not everyone, though, is talking about actual, practical ways to protect yourself from excessive costs when you obtain care at a local doctor’s office, hospital or other facility.

Asking the Right Questions

Almost all of the practical strategies for “consumer cost control” in medical offices focus on getting answers from medical providers. Asking relevant questions before, during and after a visit can help you avoid some of the most ridiculous charges that show up on medical bills.

One tip is to ask for an itemized list of charges. Itemization of a medical bill will show you whether any costs for a particular procedure have been padded or exaggerated, for example, in bills for supplies and related expenses. Some doctors have begun to bill different aspects of consultation separately and this is another area where an itemized bill can come in handy.

Look At the Medical Codes

Medical consultants are now advising to look at the CPT codes that show up on your medical bills. CPT codes represent specific procedures and treatments, and you can use these to help find a fair price online. It is becoming increasingly common for individuals to look for these kinds of “blue book values” for medical procedures when negotiating with a provider. Experts also recommend checking out the government’s reimbursement rates for Medicare and Medicaid to see if your doctor is charging you too much for a specific procedure.

Look for Alternatives

Another way to lower overall medical costs is to decline some of the more expensive and less necessary treatments that your doctor may suggest. Lots of medical advocates tell patients to always apply the “BRAIN” ( benefits, risks, alternatives, intuition, nothing) principle to their questions in the doctor’s office. This involves looking at the pros and cons of procedures, as well as what lower-priced alternatives may be available, as well as checking your intuition or “gut feeling” about a suggested treatment. Then, evaluate the consequence of delaying treatment for a health condition.

One reason that consumer advocates suggest this kind of questioning is that a doctor’s suggested treatments are not always the only course of action for any given health condition, and sometimes, a practical approach can reveal perfectly good alternatives that can come with a much lower price tag.

Look for Discounts and Other Payment Options

Another great tip is to look for payment plans and other options from your local medical providers. Many providers have begun to offer these options to patients. Some patients who are facing high-dollar bills can even qualify for charity, especially if their insurer declined huge portions of their bill. Make sure that you keep all of these strategies handy for dealing with medical bills that threaten to ruin your financial health.

What Can a Medical Billing Advocate Do For You?

Terminology and complexity are the rules of today’s healthcare system. Most consumers are not even aware that there may be hidden problems with their bills. When you are busy or not feeling well, you often don’t have the time to do the necessary work to get corrections made. You might not even realize that you are being overcharged!  

All kinds of errors are found on medical bills. We see examples of billing more than once for the same service, billing for services or supplies you didn’t receive, using the wrong diagnosis and procedure codes, unwarranted denials by the insurance company, and plain old human error. All of these causes can add up to you, the patient, paying more than you should be for your health care services.  

Medical billing advocates help individuals review medical bills for errors. We make sure that what you are being asked to pay is something that you actually owe, that you are not being over-billed, and that your insurance company (if you have one) is paying the amount it is obligated to pay.   You can think of us as medical bill analysts too. We analyze your bills and your coverage and make sure you get the benefits you are paying for.  

National reports show that 90% of medical bills have errors, and they are not to your favor! Most people do not ask for and do not receive an itemized statement showing what they are being charged for. If you went to the grocery store and they handed you a receipt that said, “produce $40, meat $100, and canned goods $50, total $190” you probably wouldn’t accept it. Why do we accept these types of bills from medical providers?  

If you are interested in hiring a medical billing advocate, where do you find one? As with most professional services, the best way is through word of mouth. You can also check out billadvocates.com, the website for the Medical Billing Advocates of America. This site offers a feature that allows you to search for an advocate. Since most of what medical billing advocates do is done by telephone and email, it isn’t necessary to hire someone who lives near you. It’s best to hire someone who has a background in health care, insurance, or related fields.  

Many  medical bill consultants conduct an initial NO-COST telephone review to help you determine if hiring a medical billing advocate makes sense for you.  In general, if your advocate doesn’t find savings, you only pay the costs associated with obtaining copies of your medical records. 

©2009 LifeBridge Solutions, LLC. All rights reserved.  

Hospital Forgives Medical Debt For 90 Year Old

A Colorado hospital forgave over $21,000 in medical debt for a local 90 year resident. Despite all the stories we hear bashing health care providers, a story where a hospital shows compassion is a welcome change of pace.

My client, Liz, owed a local hospital for services received in 2008 as a result of an accident. Liz was not eligible for Medicare, and had private insurance. After admittance to the hospital on an emergency basis, she remained there for rehabilitation treatment. Her claims were paid at out of network level, leaving her with significant balances owed. While she made small monthly payments, she never really understood why she owed all that she did and how she got into this mess.

Liz had no family to help her and lives in downtown Denver. When she called me, she pleaded with me to come down to Denver and meet with her to help her, as she was very confused about all of her medical bills. I made the trip from Loveland to Denver and sat down with her at a local McDonald’s restaurant (she told me her kitchen table in her apartment was not big enough to spread out the papers). She entered the restaurant very slowly, using a wheeled walker. As I spoke with her and looked through all of the piles of bills, I was amazed at how bright and sharp and intelligent her blue eyes were, as she seemed to understand most of what I was saying, and was able to intelligently answer my questions. Needless to say, I was impressed with her and I certainly felt compassion for her circumstances. She wanted to do what was right, and pay her fair share, but the weight of these large bills were more than she could handle.

I wrote a well thought out letter to the hospital, petitioning them to forgive Liz’s debt, and providing a rationale for why I felt that they do this. The amazing thing: I received a prompt reply from them. They agreed to bring all of her accounts out of collection, and reduce them to a zero balance, for both the hospital and for the physicians amounts owed.

What a wonderful outcome and phone call it was for me to call Liz and inform her of this great news. Imagine her relief to no longer have this burden. And, it is encouraging that the hospital administration truly do have a heart.