A surprise medical bill is an unforeseen expense charged to a patient once they receive medical treatment.
The bill includes unexpected facility fees, an out-of-network charge, a bill that is way higher than your expectation, or a balance bill.
Sometimes, even premium insurance doesn’t keep you from surprise medical costs and doesn’t cover the complete cost of the medical care at the end of a procedure.
Today many patients suffer medical bills exceeding their expected cost by tens of thousands of dollars.
What You Should Pay
- Patients need to pay only for in-network cost-sharing, such as co-insurance, co-pay, or deductibles if they go to an in-network facility.
- Patients who are treated in a non-contracted medical facility for emergency services only have to pay the in-network cost-share.
- If you have any questions about cost-sharing, contact your health plan.
To protect patients from those surprise bills for scheduled operations, here are some useful tips:
7 Tips To Avoid Surprise Medical Bills
1. Launch an Appeal
Medical bills also provide instructions on how to file an appeal if you come across an irregularity. File a formal complaint against your insurance provider in case you find out any unfair charges.
Inform your healthcare provider about the issue any time you plan to complain to your insurance company about an inaccurate medical bill.
Ask your healthcare provider not to submit the bill for collection.
While the provider is not obliged to follow your instructions, the request will give you some more time to settle the irregularity with your insurer.
2. Take Cost Estimates
Various insurers offer cost estimators to help you get an estimated cost of a specific treatment. You can also use plenty of third-party applications on the internet to assess the cost of treatment.
Once you get an estimate, contact a health care provider and take a cost estimate directly from him beforehand. Next, compare the difference between your estimated cost with that of the healthcare provider.
In case you find a major gap between them, do further research to protect yourself from any surprise bill.
3. Find Out What Your Plan Covers
Carefully read out your insurance plan to find out what’s covered, and make notes. A clear understanding of your contract will help you avoid surprise medical bills.
Always consult your insurer before undergoing any medical procedure.
4. Go Over the Bill
Thoroughly check your medical bill to make sure that everything is accurate because hospitals’ billing departments regularly handle a massive amount of data.
So, it’s common for them to make billing errors. The errors such as billing you for services you never opted for, inaccurate insurance records, or inappropriate dates.
5. Get Support from the State
Though federal regulations don’t protect patients from surprise bills, some states do hold policies to stand for patients against certain medical bills.
In some states, patients feel more secure about emergency room visit charges for in-network physicians. So, contact the state department to make sure whether or not a legal policy will protect you from any surprise bill.
6. Ask About the Payment Plan
If nothing else works, and you find out that the bill is accurate, and you have to make the full payment, take advantage of financial aid or a payment plan.
A wide range of billing departments offer payment plans with a zero or nominal interest rate to help you comfortably pay your medical bill.
7. Go to In-Network Providers
The provider network is frequently updated, so confirm from your insurer whether or not the doctor you want to see is registered in the network.
Note down the name of the insurer and the information you will get. Keep the note safely to use in case of a surprise bill.
The No Surprises Act will be a breakthrough in protecting patients against surprise medical bills. The Act will bound the providers to bill patients the same charges their insurance companies would compensate for emergency and other services at in-network hospitals.
Meanwhile, you should opt for in-network providers every time you need any sort of treatment.
In addition, you need to understand the current state protection rules and policies against surprise medical billing to get rid of any unforeseen charges that will ruin your peace of mind.
If you have any questions, please comment below now.