How to Fight a Major Medical Bill: 5 Helpful Tips

Medical bills are one of the leading causes of personal bankruptcies. The good news is that just because you receive a large medical bill, it does not mean that you are without recourse. The following are steps you can take to try to trim those bills down to size.

Organization is Critical:

A major hospital stay or surgery can result in dozens of bills. Some of the bills may be from providers, such as ambulance services, specialists, or anesthesiologists that are not affiliated with the hospital. Be sure to contact the provider if you are unsure what service they performed. Try to keep all bills in a central location, and keep a spreadsheet if necessary.

Review Each Bill:

Scour each bill with a fine-toothed comb to make sure you were not charged for items or services that you did not receive or that should be included in the hospital’s daily room charge. For example, you should not be charged for any medications that you brought with you from home. You also should not be charged extra for routine supplies, such as gloves and gowns, since these should already be calculated into the daily room charge.

Verify Network Participation:

If you use a facility or provider that is out of your insurer’s network, you may be billed for the difference between what your insurance covers and the total charge. If you receive treatment from an out-of-network facility or provider due to a medical emergency, check to see if you are being balance billed by the out-of-network provider. Some states have regulations prohibiting balance billing in these types of situations, so you should check with your state insurance regulator.

Be Willing to Negotiate:

The following can give you a starting point for your negotiations.

• Go online or call other hospitals to find out how much they charge for the same procedure.
• Offer to pay a percentage of your insured’s reimbursement rate instead of the amount charged to uninsured patients.
• You can also use Medicare reimbursement rates as a starting point.

Hire a Pro:

It may be worth your while to hire a professional patient billing advocate. These experts will do all of the legwork on your behalf. They are also well-versed in billing codes and practices, which are often confusing to the lay person. Most of these agencies charge 20 to 30 percent of what they save you.

Ask About Financial Assistance:

Many hospitals offer patient assistance programs to individuals meeting certain financial criteria. Of course, you may have to apply and be turned down for Medicaid before you can be approved.

Finally, you should act quickly. Providers are much less willing to work with you if the bills are months past due.

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