Medical Bill Help: Compare Healthcare Costs Before Proceeding With Treatment

The costs of medical and health care services have been rising steadily for many years, and American consumers are feeling the pinch in a big way. Many American individuals and families are now facing extremely high medical debts, some of them for fairly routine or minor health care procedures or treatments. With the private insurance system looking to offset costs, and very little in the way of a safety net for consumers, medical bankruptcy threatens many thousands of families each year.

Now, medical advocates are telling American patients to go a step further than many of them are accustomed to: new guidelines from experts in the industry suggest that consumers should be asking medical providers about how much a certain procedure, treatment or even a consultation may cost before they ever step in the door of the medical office.

Barriers to Asking Questions About Healthcare Services

In prior times, most patients were not used to asking their doctors what something would cost – there was a kind of intuitive understanding that since medical care is something that nobody wants to skimp on, it’s not a situation where prices can be negotiated. Over time, that led up to a system where insurance plans, largely those provided by group employers, covered major costs, leaving a patient with a straightforward co-pay or deductible that would represent their total financial responsibility.

These days, even a group plan doesn’t protect the average consumer from receiving extremely expensive medical bills after getting nearly any kind of health care service. Larger co-pays, larger deductibles and co-insurance mean looming costs for many Americans as medical costs continue to skyrocket and other issues like deceptive out of network charging leave many patients with much more debt than they thought they were going to incur when they arrived at a hospital or other facility.

Can Americans Shop for Health Care?

What new reports are showing is that the best way to shop around for health care is to ask your insurance company. Most of the efforts at cataloging the various rates that different providers charge for services are done by big insurers like CIGNA, Anthem Blue Cross, and other multi-state insurance companies. Patients can also ask their insurance company which providers have a contractual plan that forces them to charge a certain set price for a given medical service.

Over time, this trend will probably continue, to the point where American patients routinely ask their insurance company to help them shop. For most enrolled members, the insurance company has a vested interest in that person getting the cheapest medical care possible. While these kinds of partnerships between private insurers and individual patients can help both parties to rack up less medical debt for the same kinds of treatments and procedures, there’s also a great need for more patient education, where consumer advocates are standing in for states and the federal government when it comes to providing fixes for a problem that is challenging the majority of American families today.

Be Your Own Patient Advocate Before Surgery

When planning for surgery it is useful to learn the art of being your own patient advocate. Today’s health and wellness industry has made it easy for us to obtain information to ensure we receive quality care. When we do our own thorough research ahead of time we can feel confident about having a positive surgery outcome.

How to be a patient advocate in navigating health insurance:

It is important to have a full understanding of your health insurance plan. Here are some of the things I learned this past year:

· When in need of a new insurance plan seek out a local insurance broker to help sort out the best plan for your specific needs. Free of charge, they help us attain emotional health about the coverage we choose. These agents know which plans do not raise their rates yearly, which ones are most appropriate to choose with pre-existing conditions, and which plans will be available long-term.

· Whenever you receive a new insurance plan you need to become your own patient advocate by reading through the policy right away. This will inform you if they have placed any restrictions on covering any of your current medical conditions. You do have 30 days to cancel the plan if you find the policy unacceptable.

· If a situation presents where you are not able to pay your medical bill you can make alternative payment arrangements. Those with financial hardships are able to reduce their hospital fees or perhaps waive them entirely.

How to be your own patient advocate for medical visits:

· The health and wellness industry has been great at educating us how to prepare ahead of time for a medical visit. Most of us have already experienced the value of writing down our questions before the visit. To optimize your limited time with the doctor I advise asking your practitioner only those questions they themselves can answer. As my own patient advocate I have learned to query other staff with the remainder of my questions. For example:

1. Direct inquiries about pre-post surgery issues to the surgery scheduler.

2. Ask the front desk staff how to obtain the morbidity & mortality statistics for the doctor and hospital.

· The health and wellness industry has encouraged us to have a trusted person with us during the medical visit. When another is present it allows them to become your patient advocate. I have found their presence vital since way too often my trusted friend brings up issues I failed to mention. It helps me take care of my emotional health when the trusted person is my scribe and documents the doctor’s comments.

· When you need a physician to submit a form (or write a letter) on your behalf it is best to prepare ahead of time. Here are a few examples:

1. When requesting a temporary handicapped parking permit find out ahead of time if the DMV requires you to download their form. If not, draft a letter with your request for the doctor to sign.

2. Whenever you need the doctor to write a letter confirming a medical condition it is best to become proactive as your own patient advocate. Arrive at the medical visit with a sample letter which includes all the pertinent information so you leave with it in-hand.

3. When you need a medical test ordered at another facility come prepared with the name of the facility and FAX number where the request can be sent.

When you follow these guidelines chances are greater you will leave the visit with total confidence that your needs are being handled.

How to be your own patient advocate before and after surgery:

· Know that you can request an early morning surgery when necessary. In taking care of your health and wellness inform the surgery scheduler of needs for early morning surgery if you have health issues that would be compromised when pre-surgery requirements forbid the intake of food or water. Prior to surgery it is best to take care of your emotional health and speed up the time your body is without nourishment.

· It is desirable to have a trusted friend stay in your hospital room overnight. If something unusual presents they can be of immediate value. Today hospitals have a chair that folds down into a bed for these specific purposes.

How to be your own patient advocate in finding the best surgeon:

· The health and wellness industry has made it easy for us to do research online. In your inquiry, seek out the latest state-of-the-art surgery technologies. After studying the various options you are more ready to select a surgeon.

· Search for doctors that use minimally invasive surgical techniques to reduce pain, restore mobility, and promote a quicker return to normal activities.

· In being your own patient advocate you may find the need to look outside your local area for a surgeon. Surgery is an invasive medical procedure. It is in your best interest to feel confident you will receive the highest quality of care.

· I encourage you to inquire how experienced your potential surgeon is. You want someone who has done the procedure hundreds of times to ensure the best outcome.

Hopefully you feel more feel confident about being your own patient advocate when planning for surgery. There are countless online resources available to help sort through the maze of information. Use these guidelines when seeking out what is available and you will find balance in your emotional health.

Do You Need a Medical Billing Advocate?

Do you have a stack of unpaid medical bills? Not sure if you really owe all that your doctor or hospital bill is claiming you do? Did your insurance cover less than you thought they would? Do you have an elderly relative that has been ill and the bills are piling up?

If you have answered yes to any of these questions, it may be time to consider hiring a medical billing advocate to review your bills to determine if you owe what is being claimed. After all, it is reported that 8 out of every 10 medical bills contain errors, and the majority of patients and consumers have no idea that they are being over-charged for medical services that have been rendered (and sometimes not rendered at all). It’s not unusual for billing advocates to detect data entry errors, unbundling of charges (charging for procedures separately, when they are included in one code) erroneous billing for services never received – honestly, the list is infinite.

If your insurance company rejects a service, the provider may simply send you the bill rather than researching and resubmitting the charges for payment. How would you know if this is the case? How would you know that your insurance should cover the charge? It’s so important to have someone knowledgeable review your bills so that you aren’t placed in a position of feeling coerced into paying medical bills for which you may not even be liable.

Medical Billing Advocates review your bills by combing through them, line by line, and also carefully examining the explanation of benefits from your insurance company. They will subsequently compare the charges to your medical records, to ensure that you did in fact receive the services for which you are being billed. This will leave you with peace of mind, knowing that you are only paying for services that were legitimately rendered, thus eliminating the risk of paying thousands of dollars of medical bills for which you are not responsible.

You can be certain that Medical Billing Advocates have the expertise needed, and thorough knowledge of the codes used and how to read a medical record to determine if all charges are appropriate. Additionally, professionals will know what codes can be billed together, and what codes cannot, and when the provider is required to write off charges that have been billed in error, and when you are actually responsible.

It’s time to be proactive. Remember, it’s within your rights to obtain all the assistance you need, and it’s unnecessary to pay another dollar for which you are not responsible.