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How to Avoid Overcharges from Medical Service Providers

OverchargeI have worked in the health insurance industry for years and firmly believe that you should do everything you possibly can (while maintaining moral, ethical, and — of course — legal standards!) to keep more of your money in your wallet rather than hand it over to insurance companies, hospitals and medical service providers.

Unfortunately, hospitals all too often overcharge their patients for services provided. Most people are unaware that there are many different ways to avoid being charged (and overcharged!) while still receiving quality medical attention. Hospitals and other medical service providers bank on the fact that few patients even look at their hospital bill, much less dispute charges! Human error can certainly account for some of the charges, but regardless whether they are mistakes or not, you should not have to pay extra!

I have compiled a list of some ways you can prevent paying more than you should for your medical services in the hopes that it will help you manage your health care dollars more efficiently.

Comparison Shop When Possible

If you are having a heart attack and need to seek out medical services immediately, you are obviously not going to stop and make phone calls to find out which hospital is going to charge you less. But what if you are going in for a routine, scheduled procedure?

A great way to make sure you are not paying more than the going rate is to compare the procedure process at several different hospitals. You can call ahead to find out what the charge for a standard room is as well as what items are included in that charge. You might be surprised about how much the price can vary from hospital to hospital!

Verify Whether Providers Are in Your Network

You should also contact your insurance carrier prior to scheduling the procedure to find out which services they will cover. You should make sure that everyone taking part in your care and recovery (including anesthesiology, labs, etc…) is part of your network in order to avoid those high out-of-network charges.

Use Your Own Personal Items

A scheduled hospital stay also allows you the time to gather up your own personal belongings to use while recovering. For example, shampoo, soap, tissues and other toiletries are not typically included in the cost of the room. Make sure you bring all necessary items from home in order to avoid having to use those provided by the hospital. Your personal toiletries will also help you feel better, as the hospitals items are likely not as nice as yours.

The same also applies to your prescription medications. The hospital will provide your daily medications for you, but the cost is inflated considerably. Make sure you bring in your prescriptions and make sure the staff is dispensing them correctly.

Keep Track of Services Performed

You might be surprised to find out how many patients are charged for diagnostic testing that wasn’t even done. For example, imagine the surprise of a male patient who is in the hospital for a knee replacement and was charged for a pregnancy test!

If you are able to, write down every test performed and why. Or, have a trusted family member or friend keep track of these for you. This way, you can be sure you are only paying for testing and procedures that were actually done!

Review Your Bills Carefully

When you receive the summary of benefits provided by your insurance carrier, make sure you compare it with the actual bill from the hospital and related services. Make sure you have an itemized bill (without obscure charges like “miscellaneous lab fees”) from the hospital as well. This will help you recognize when an error has been made, as the benefit summary and hospital bill should contain the same items.

Don’t Be Bullied

Many hospital billing departments give you the impression that you have to pay your bill before you are allowed to leave the hospital. This is entirely untrue, no matter how adamant they get. Remember that you have time to review all of the charges and make sure you are paying for what you are supposed to be paying for! Also, if they continue to try to get you to pay immediately, you can almost guarantee you are going to be overcharged.

You Can Negotiate Your Remaining Bills

Once you have received your Estimate of Benefits and the hospital bill and have had the chance to compare the two, you can contest any charges you find that are different on the two. Once those have been taken care of, you are left with your portion of the bills.

However, even after your insurance company has made their payment, it  does not always mean you have to pay the entire bill amount. You can often negotiate with the hospital and other providers to lower your bill even more. In many cases, a hospital is willing to take a lower amount if you are going to pay it in full. This saves them the time and cost involved with sending out monthly statements.

If negotiating your bills on your own makes you uncomfortable, you can hire a bill negotiation service. These can be a great help in reducing the amount you have to pay.

We offer a bill negotiation service for our customers which can help you reduce your overall payment amounts. If the amount of a single bill is greater than $250, the service can negotiate on your behalf and often get it significantly reduced. For more information about our bill negotiation service, visit our Additional Benefits page that details the service.

Most bill negotiation services will charge you up to 35 percent of any bill they negotiate on your behalf. If the bill is a large one, you can still save a large amount of money by using this type of service.

The Bottom Line

The bottom line depends on your perspective. For hospitals and other medical providers, the bottom line is about making a profit. After all, they are operating a business.

For you, the bottom line is all about saving as much money on your medical expenses as you possibly can. My bottom line as an insurance professional is to help you learn the variety of ways you can make that happen.

Author: Wiley Long
Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.

 

 
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