In a recent survey conducted by YouGov, almost 40% of adults find medical bills confusing. As a healthcare consumer, it is important to understand how to spot errors and discrepancies on your medical bills to save time and money.
How to Spot Errors on Medical Bills
The best way to avoid overpayment or incorrect billing is through proactive measures. When you receive a bill from your healthcare provider, review it thoroughly. Patient statement bills can be overwhelming to read, as they contain technical language and abbreviations that may be unfamiliar to most people. Statements should be simplified with the necessary information to make it easier for you to pay.
It’s important to understand what is included in these statements as it will allow you to accurately track your expenses and identify any discrepancies in billing. Common key items on patient statements include:
Procedure codes – you may see several line items comprised of numbers and or letters. Each procedure code corresponds to a specific type of service or product provided by your healthcare provider (i.e. office visit, lab test, screening, etc.). These codes are used by insurance companies to determine how much they will cover for each service provided.
Finance/interest fees, late charges.
Insurance adjustments and payments.
Payment due date.
Where to mail your payment.
Online payment option.
Look for any discrepancies between the services that were provided and what was billed. Common errors that happen:
Duplicate charges. Sometimes providers will accidentally add multiple charges for the same item which can result in an overcharge. You could unknowingly overpay if the bill was not reviewed.
Services not received. This is a test or procedure that was not performed but incorrectly added to the bill.
Incorrect payment terms and dates. If there are any discrepancies between what was originally discussed with your provider and what appears on the bill, contact them right away so that they can help resolve the issue quickly and efficiently.
Inaccurate balance due. Compare the total sum of what you owe with any copayment amounts, previous patient and or insurance payments. This will help ensure the balance ties out accurately.
Balance billing. This is when you are charged for a balance that should not be your responsibility.
It’s also important to understand what your insurance company covers. If there are services listed that you know should be covered by insurance but aren’t, this could be an oversight or error in billing. If you see something that doesn’t look right, contact the billing department immediately and explain the issue.
Before you schedule any appointments or procedures, check with your doctor and your insurance company first so you can get an estimate of how much will be billed for each service performed and expected coverage. This way, you won’t have any surprises when the bill arrives later down the line. Additionally, always double-check the accuracy of information such as dates of service and codes used for medical procedures. Small mistakes can add up quickly and create problems later when figuring out what went wrong and obtaining a resolution.
If You Do Receive an Incorrect Billing Statement
If you do receive an unitemized, confusing, or incorrect statement from your healthcare provider, keep calm! The first step is to contact them directly and inquire about any discrepancies in the bill—this is often all it takes to resolve the issue quickly and accurately. If this doesn’t work, contact your health plan administrator for assistance resolving disputes with providers or insurers over claims or payments (they may even offer help with filing appeals if necessary). We have heard, however, some administrators place the burden back on the patient or follow through doesn’t happen like it should. When this happens, stand firm and keep on top of the situation. You may have to initiate follow-up more often than you think necessary. If all else fails, do some research into local advocacy programs in your area—many areas have these types of resources available specifically designed to help patients navigate complicated billing statements and other issues related to healthcare payments and collections.
It's critical that patients review their bills carefully before making any payments. Errors could mean hundreds of dollars in unnecessary costs that come out of your pocket if not caught early enough! Fortunately, there are steps you can take both before receiving a bill (checking coverage options before scheduling services) and after (contacting the provider directly) that can help save both time and money while avoiding potential headaches caused by inaccurate billing statements. When dealing with healthcare collections issues due to inaccurate billing statements, remember—you don't have to go it alone if you don’t want to or don’t have the time! Resolving a problem bill can take a couple of hours of phone calls to over one month plus – it depends on the billing issue complexity and response time of the other party. Still, it’s always better to reach out directly, to be persistent and follow up regularly - rather than risk paying more than necessary. Being informed about your rights as a patient and knowing exactly what should appear in your statement will go a long way towards making sure you are able to confidently self-advocate.
Need more help with resolving a medical or dental bill issue? Contact your area's local patient advocate or reach out to MBCR today!