Is Your Insurance Company Paying Your Medical Bills? Make Sure They Do
Medical insurance companies don't like to pay your medical bills, believe it or not.
You really need to pay close attention to each bill you receive and what the insurance company pays.
This can be a daunting task.
If you have several bills coming in, you are probably experiencing some scary medical issues so you're already not at the top of your game.
I have a lot of sympathy for anyone who's been sick, and especially for the elderly, who may no longer have anyone to help them.
It's a lonely feeling once you're home from a hospital stay and you still have life to deal with.
You're not fully recovered, you may still feel sick or be experience pain, and the bills that start flooding your mailbox don't make you feel any better.
If you've had to spend any time in the hospital, you understand that the bills just don't end.
You pay the hospital, the doctors; you pay for tests, x-rays, the radiologists, the ugly brown footies, and so on.
You think you've got a handle on it, and then another bill shows up from a company you've never heard of.
Because you're at your most vulnerable, it's easy to not pay attention to that stack of bills.
Insurance companies will use this to their advantage.
When my second child was born, I had complications and had to be re-hospitalized when she was three weeks old.
So on top of the bills from the birth, came a second set for another hospital stay - including the hospital, the doctors, the tests, the radiologists, and the ugly brown footies.
It was overwhelming.
And I understand it.
For those who don't, I imagine it could be brain-numbing.
So what can you do? First of all, try as best you can to stay organized.
You will get a ton of bills and it's a good idea to know where they're coming from.
You see, when you spend time in the hospital, you incur charges from everyone, and for everything.
You will get the hospital bill, of course, and your own doctor's bill; any specialist who popped by your room to see you for two minutes, all tests performed - lab work and more costly exams, like a CT scan, for instance.
You pay for the radiologist to read, or interpret, the scan, and you pay for the actual performance of the exam by the technologist.
Maybe an anesthesiologist if you had surgery; casts and bandages; prescription drugs you take home.
And yeah, those darn footies - you'd think they'd be happy to get rid of the ugly things.
Your insurance company sends you what is called an EOB, or Explanation of Benefits.
This is a form that tells you how much you were charged for a particular service, including doctors' fees and tests; plus how much the insurance company is obligated to pay based on the contract they have with the provider of the service, and finally, the amount that you have to pay.
What you need to do is match the bill from the provider of the service with the EOB to see that they agree.
Here's something that throws people off all the time.
It's very common today for hospitals to contract with different types of medical specialists, including radiologists, surgeons, orthopedic physicians, obstetricians, and whatever other type of specialist you can think of.
These doctors own a private practice where they perform outpatient services.
They also have a contract with a hospital for which they provide the physician services in exchange for having exclusive rights to the hospital.
Let's say for instance, you have that CT scan.
If you have the scan while you're staying in the hospital, you will be charged by them for the exam itself, plus you will get another bill from the radiologist's private practice for the interpretation services they performed.
If you have a CT scan at a private practice, you will only see one bill because the radiologist is providing the facility and the interpretation.
Know your benefits, keep your bills organized, and question anything the insurance company does that you feel is not right.
If you think a bill should have been paid, question it.
Your bills may slip through the cracks and end up not being paid if you don't stay on top of them.
The medical providers don't care if you have insurance.
Ultimately, it's your responsibility to pay the bill, so make sure that your insurance is paying what it owes.
I've wasted a lot of hours on the phone with insurance companies explaining to them why they should have paid a particular bill.
They couldn't argue.
I had behind me the knowledge of over 20 years in the medical and insurance industries.
Whenever you talk to someone at your insurance company, take notes - time, date, and who you spoke with, plus all pertinent details.
Keep everything in a file - an accordion file with alphabetic slots works well.
Unfortunately, there will be times when you'll have to discuss the payment of the same bill more than once.
You really need to pay close attention to each bill you receive and what the insurance company pays.
This can be a daunting task.
If you have several bills coming in, you are probably experiencing some scary medical issues so you're already not at the top of your game.
I have a lot of sympathy for anyone who's been sick, and especially for the elderly, who may no longer have anyone to help them.
It's a lonely feeling once you're home from a hospital stay and you still have life to deal with.
You're not fully recovered, you may still feel sick or be experience pain, and the bills that start flooding your mailbox don't make you feel any better.
If you've had to spend any time in the hospital, you understand that the bills just don't end.
You pay the hospital, the doctors; you pay for tests, x-rays, the radiologists, the ugly brown footies, and so on.
You think you've got a handle on it, and then another bill shows up from a company you've never heard of.
Because you're at your most vulnerable, it's easy to not pay attention to that stack of bills.
Insurance companies will use this to their advantage.
When my second child was born, I had complications and had to be re-hospitalized when she was three weeks old.
So on top of the bills from the birth, came a second set for another hospital stay - including the hospital, the doctors, the tests, the radiologists, and the ugly brown footies.
It was overwhelming.
And I understand it.
For those who don't, I imagine it could be brain-numbing.
So what can you do? First of all, try as best you can to stay organized.
You will get a ton of bills and it's a good idea to know where they're coming from.
You see, when you spend time in the hospital, you incur charges from everyone, and for everything.
You will get the hospital bill, of course, and your own doctor's bill; any specialist who popped by your room to see you for two minutes, all tests performed - lab work and more costly exams, like a CT scan, for instance.
You pay for the radiologist to read, or interpret, the scan, and you pay for the actual performance of the exam by the technologist.
Maybe an anesthesiologist if you had surgery; casts and bandages; prescription drugs you take home.
And yeah, those darn footies - you'd think they'd be happy to get rid of the ugly things.
Your insurance company sends you what is called an EOB, or Explanation of Benefits.
This is a form that tells you how much you were charged for a particular service, including doctors' fees and tests; plus how much the insurance company is obligated to pay based on the contract they have with the provider of the service, and finally, the amount that you have to pay.
What you need to do is match the bill from the provider of the service with the EOB to see that they agree.
Here's something that throws people off all the time.
It's very common today for hospitals to contract with different types of medical specialists, including radiologists, surgeons, orthopedic physicians, obstetricians, and whatever other type of specialist you can think of.
These doctors own a private practice where they perform outpatient services.
They also have a contract with a hospital for which they provide the physician services in exchange for having exclusive rights to the hospital.
Let's say for instance, you have that CT scan.
If you have the scan while you're staying in the hospital, you will be charged by them for the exam itself, plus you will get another bill from the radiologist's private practice for the interpretation services they performed.
If you have a CT scan at a private practice, you will only see one bill because the radiologist is providing the facility and the interpretation.
Know your benefits, keep your bills organized, and question anything the insurance company does that you feel is not right.
If you think a bill should have been paid, question it.
Your bills may slip through the cracks and end up not being paid if you don't stay on top of them.
The medical providers don't care if you have insurance.
Ultimately, it's your responsibility to pay the bill, so make sure that your insurance is paying what it owes.
I've wasted a lot of hours on the phone with insurance companies explaining to them why they should have paid a particular bill.
They couldn't argue.
I had behind me the knowledge of over 20 years in the medical and insurance industries.
Whenever you talk to someone at your insurance company, take notes - time, date, and who you spoke with, plus all pertinent details.
Keep everything in a file - an accordion file with alphabetic slots works well.
Unfortunately, there will be times when you'll have to discuss the payment of the same bill more than once.