Posted by How many times have you ever tried to closely overlook your medical bills? In daily routine, people usually do not pay attention to this. Most of the time, they simply pay our medical bills and keep things sorted. Well, this practice isn’t good at all. Who knows, there may be some sort of error in your medical bill. What if medical billing services are charging extra money from you? If the medical billing services are doing it intentionally, then it’s immoral. It’s a healthcare fraud and must be reported. However, in many cases, mistakes are as simple as typo mistakes. But still, they must be avoided as they might create big blunders.
Hardly, few people look into their billing details. Raise your hands if medical bills seem perplexing to you at a single glance! Well, no worries, you are not alone here. Your insurance providers usually do it on your behalf and immediately deny such bills.
Best Practice to Figure Out Billing Errors
Anyhow, you have to handle the bills for out-of-coverage medical services. So, if you suspect fraud, use these six actions to find the problem and correct the annoying medical billing problems.
Check 1–Be Aware of your Health Plan Coverage
Whenever you select an insurance plan, they provide you with an EOB. You must check out the coverage area of your healthcare plan before choosing it. Also, you can find the plan’s summary of benefits on their website. Reach for it anyway and read it thoroughly. Particularly focus on the non-covered medical services portion. Check out the limitations applied as well. Second, you must know your provider’s network details. Third, you must have a clear idea of the deductibles, copays, out-of-pocket limits, and coinsurance. Fourth, check if your insurance plan takes responsibility for medication or not. The payers usually revise their policies over time, mostly on an annual basis. Thereby, you must check out the new policies too.
Check 2–Cost of Care Matters
Considering a screening test or surgical procedure? Get ready to tackle all of your medical expenses like a pro. Don’t let the expenses surprise you! Here’s what you can do:
- Discuss the specifics with your doctor.
- Obtain those billing codes from the billing department.
- Then, inquire about coverage details with your insurance. You can simply do so by making a call to your insurance company.
- See if they offer a smart cost estimate tool on their website. It’s your frugal superhero!
- Ask your doctor to provide you with a written estimate of your out-of-pocket costs. Save it for when you receive the bill later.
- Ask your doctor or organization for a “good faith estimate” if you don’t have insurance or plan to pay out of pocket. You may call them out if they overcharge you by $400 or more!
Check 3–Recheck Your Medical Profile and Related Docs
Usually, the provider sends the bills using their medical billing services. Many times, patients get more than one bill. For instance, your attending physician in an emergency case is different.
Then, you are referred to another doctor for further treatment. Medical billing services give you bills for the services you get from both of them. You must check out the paperwork of the physician and your insurer thoroughly.
Keep the Explanation of Benefits (EOB) your insurer provides you in mind; it has important info. The EOB lists the covered services and insurer payments. In other words, it lists your financial responsibilities to the provider (which should correspond to the bill). For documentation purposes, be sure to file the EOB with all of your extra bills. Take action and contact your care provider or insurance if you see any differences. Keep in mind that many hospitals provide financial counselors as an extra source of assistance.
Check 4–Act Quickly on False Bills from Medical Billing Services
Now, if you suspect any error in your bills, you can simply turn to your insurers. CMS has forwarded its ‘No Surprise Act’ to save patients from surprise billing if they get services from out-of-network providers.
Pay attention! Don’t lose time if you believe your bill contains an error! Contact your provider or insurer as soon as possible. If your debt is over $500, some providers may only offer you 30 days to pay it. This might harm your credit score.
Check 5–Get Assistance in Resolving Billing Disputes
Don’t get caught up in a communication mess with your insurance or care provider. We have fallback plans if they’re not being kind! You can contact CMS online or by phone at 800-985-3059 for the No Surprises Help Desk. They will investigate your complaint. Thus, they ensure that medical billing services and insurers are abiding by the guidelines fairly. And if they’re unable to resolve it, they’ll put you in touch with the consumer assistance program in your state!
Endnote
Medical bills are scary, but paying a fraud bill is the worst. Therefore, you must check your bills for good reasons. Also, medical billing services must be vigilant enough to avoid billing mistakes as much as possible. They must implement automated billing systems to minimize errors. Also, they can improve the quality of the bills by choosing the right medical billing outsourcing company. And QPP MIPS is the right medical billing outsourcing solution for all such providers.