Save Money By Verifying Your Medical Bills
A couple of months ago, our son spent some time in the hospial and underwent numerous tests as the doctors attempted to diagnose the problems he was having. Fast forward to now and we are starting to get the bills from the hospital, laboratories, doctors and specialists.
The pile of papers can become quite daunting, as there are the bills from the service providers as well as the statements from the insurance company on what portion of the bill they will cover. If you are not diligent with your record-keeping, it would be far too easy to trust the insurance and service providers to send you accurate information and pay the bills that you receive.
However, you really need to take the time to review the bills and explanation of benefits from your insurance as mistakes are quite common. In our situation, the one mistake that we just discovered was a bill from one of the laboratories. The total amount of the bill was $486 and our insurance made a contractual adjustment of $161.00 and a payment of $21.60, leaving an unpaid balance of $303.40.
According to the Explanation of Benefits from the insurance company, we would only owe $20.70 out of that $303.40 for the following reason:
Your health care plan covers eligible services up to an allowed amount for services ordered or provided by a participating provider. Since this amount has been paid, no further payment can be made. You are not responsible for the charges over the allowed amount.
While we are not responsible for the full amount of the unpaid balance, that did not prevent the laboratory from sending us a bill trying to collect the full $303.40. This morning my wife called our insurance provider to verify that they reported everything accurately and confirm the amount that we are expected to pay.
While on the phone with the insurance provider, the representative conferenced in someone from the laboratory to discuss the bill that we received. When questioned about why we received a bill from the lab for the full amount, the representative denied that any bill was sent to us and that we only owe the $20.70 mentioned earlier. My wife explained to the representative that we have a bill in our possession indicating a balance of $303.40, yet they still denied that they ever sent a bill.
I found it quite interesting that the representative from the lab was trying to deny sending us a bill for the full amount while they were conferenced in with the insurance provider. Immediately that made me think that they were trying to cover something on their end and I need to do some investigation, as I wonder if that violates any of their contractual agreements with the insurance company or something along those lines.
Needless to say, the lesson here is that it is very important to closely examine your medical bills for clerical errors and inaccurate billings. In my opinion, this laboratory sent us a bill for the full amount in an effort to bypass the adjustments made by the insurance provider. In many cases, people may unknowingly pay that full amount because they do not examine all of the bills in detail. If we did not question the amount of the bill, would they have credited us back the amount that we overpaid? While I would like to think that they would, I do have my doubts.
If you find yourself with a handful of medical bills, please take the time to examine everything in detail and question anything that you do not understand or believe to be incorrect. In this example that we just experienced, we *saved* $282.70 by taking the time to question the laboratory on the bill we received.