I am the power of attorney for several elderly people and manage all their finances. This includes medical bills. Here are some of the things I've learned in dealing with medical collections:
1. Mistakes are common and you should read your bills carefully. You may receive bills for the same services that are formatted differently, include other charges, or otherwise don't look identical.
It's very difficult to keep track of medical bills. If extensive services are provided, there will be tons of bills and often bills will be duplicated. I keep logs with service dates, and underneath each date I write a brief description, including what was provided and when I paid and the insurance breakdown. Hospitalizations after surgery are the most tricky to keep track of, because bills may come from many different practices. The anesthesiologist usually bills separately.
2. Coding errors are common and may result in non-payment by the insurance carrier.
For each procedure, the provider must submit a code to the insurance company. These codes often will determine whether or not insurance will pay.
In general, if you know you are going in for a test, call your insurance company in advance and ask under what circumstances your test is covered. Then make sure to ask your provider to use the specific coding. For example, tests are often covered if they are preventative but NOT if they are diagnostic.
If your provider has incorrectly submitted the code and the insurance company tells you this is why they have not paid out, don't pay the provider and then attempt to get the money back. This lessens the provider's motivation to resubmit the bill with the correct coding.
3. Out-of-network providers may not be covered at the same rate or may not be covered at all.
This may be negotiable with the insurance company, especially if you had no choice in the matter (e.g., an anesthesiologist at the hospital who you never got to choose). Always ask. Document your phone calls with brief written notes.
4. Writing letters and documenting requests for bill errors to be corrected is good. However, the bill payment address is not the best place to send letters. You may wish to send certified mail to the practice address.
It is very frustrating, but if you find an error and write to the address listed on your bill (usually a P.O. box), most likely nobody will ever answer. The address on the bill is usually just a payment processing center. It would seem logical that correspondence would be forwarded, but it doesn't seem to be. Even when the bill has two addresses listed, and one address has a note that reads "do not send correspondence to this address," the other address probably isn't any good for correspondence either.
I sent several letters requesting that billing errors be corrected but received no response other than having the account turned over to collections. One bill hadn't been submitted to insurance despite the fact that I'd sent copies of the insurance cards AND filled out the back of the bill where it requests insurance information. The billing office later told me that they don't know if letters to that address are ever answered. WTF?
5. Calling the billing office is sometimes helpful, but leaves you without documentation. Follow up by writing a brief summary and send it to the medical practice address.
Calling the billing office is even better if it's actually staffed by somebody at your doctor's practice. If you make calls, ask for names and make notes for your own records.
6. If the bill is turned over to collections erroneously, make sure to respond to the collection agency as well as the provider.
I did this by phone and by certified mail. I included copies of all the letters I'd previously sent.
6. If you legitimately owe a bill and it's a large amount, most providers will allow you to work out a payment plan that is comfortable for you.
They mostly want to see that you're paying regularly. It is easier to set up a payment plan before the bill goes to collections.
TLDR: Read bills carefully, make reasonable requests, document everything.
Submitted April 01, 2017 at 10:27AM by fu_ben http://ift.tt/2omlgnG
