Many people get medical bills from a hospital stay and don’t know what to look for to determine if the bill is correct

1. No “Balance Billing”: You should make sure that if you went to a doctor who is in your “network,” you should not receive a charge for the visit (other than a possible co-pay). When the doctor charges you the difference between their normal charge and what the insurance company will pay for the service, this is called “balance billing.” You should not get a bill from the doctor if you went to doctor who was “in network.”
2. Check Quantity: If you were in the hospital, you will want to check the quantity of items and services you are being billed for. For example, look at medications and the amount of days you were in the hospital. Hospital billing departments often make mistakes.
3. Duplicate Charges: Make sure you were not billed twice for a procedure or a lab test.
4. Upcoding: Many healthcare services have levels of care. For example, you can go to the ER for something simple – which should be billed at the lowest level of care or for something very complex – which will be billed at the highest level of care. You should look at the bill to see what was charged.

Looking closely at your bill can save you money.

Tell us whether you have had any problems with your medical bills? We’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post How to Find Medical Bill Errors appeared first on MyHealthSpin.

Many healthcare providers require you to pay for your healthcare service and then you submit the bill to your insurance company.

So how do you do you get your insurance company to reimburse you for the bill?

1. Get the proper form from your insurance company. You can often get the form from your company’s HR department or go to your insurance company’s website.
2. Make sure you get a complete copy of the bill from your medical provider. You want a bill that details all the services you paid for.
3. Ask your provider if the bill they are giving you includes all of the services and has the proper billing codes. An insurance company will not pay the bill unless the doctor has put the proper diagnostic and billing codes on the bill.
4. Make sure your name and address is correct along with your correct birth date. Your insurance claim will be rejected if there are any mistakes.
5. Once complete, submit the form with the bill. Many insurance companies now have a website where you can check to see when they received the form and when your payment was processed.
6. Monitor your insurance company to make sure you receive your payment. If they reject the claim, find out why. Often, the doctor has made an error on the billing statement.

Following these 6 easy steps will help you get your insurance claims paid fast and easy.

Tell us whether you have had any problems getting your medical bills paid by your insurance company? We’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post 6 Steps to Submit Your Healthcare Bill to Your Insurance Company appeared first on MyHealthSpin.

This question comes from a reader and the answer just may be yes.

It’s hard to believe but Sarah got a long bill from a hospital for her 9-year-old son who had to be rushed to the ER. When Sarah looked closely at the bill, she realized that included in the bill was a charge for a pap smear. Really? She called the hospital three separate times and they said they would look into it, however, they kept sending her the same bill.

She wrote and asked me what to do?

First, I told her to document every conversation in writing. Get the hospital representative’s name, title and either a physical address or an email address. After each conversation, document in writing the details on the conversation and the date and time you talked to the person.

She also needed to ask when the problem would be fixed. Often, the hospital has a different department who handles billing from the department who handles collections. You want to make sure that the error is fixed before you get sent to collections.

If she still wasn’t getting the problem fixed, I told her that every hospital has a patient relations department and a compliance department. Both departments are good resources when the billing department is not fixing the problem in a timely manner.

For Sarah, we found the compliance officer at the hospital and he fixed the problem immediately and apologized for the error.  

If Sarah still wasn’t able to get the problem fixed, she could have reported the hospital to the local healthcare fraud division. Billing a person’s insurance for the wrong service may be a simple mistake or it could be fraud. Your insurance company has a fraud division and so do the government insurance programs. For government programs such as Medicare or Medicaid, you can contact them through their website.

Tell us whether you have found mistakes on your medical bills.  We’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post Is My Medical Bill Wrong? appeared first on MyHealthSpin.

For many the answer is no. Sometimes it appears that some items are covered one time and not another. How do you figure out whether the information is correct?

We need to start with how to read the health insurance statement. Most insurance companies send you a form after each of your healthcare visits called an “Explanation of Benefits” form (or “EOB” for short). This form will list all of your healthcare services and what is being paid for each service. The form should include the services for everyone in your family that is covered by the policy.

It is important to review each EOB you receive. It is surprising how often healthcare providers bill the wrong services or bill the correct services to the wrong person. Some organizations have reported that 8 out of 10 hospital bills have errors on them. It pays to check.

Second, you want to compare what is being covered with your insurance plan. You probably have a deductible and co-pays on your policy. When you review the EOB, you should see that your insurance company is paying the proper amount for the services.

This is often why you cannot easily figure out your EOB. For example, if you get services at the start of the year, many items might not be covered because you haven’t yet met your deductible. However, some services, such as preventative care, may be covered without first needing to meet your deductible.

Checking your EOB can often save you thousands of dollars by making sure the insurance company pays the correct amount.

Have you had problems reading your health insurance bills? We’d love to hear from you!

MyHealthSpin helps you Spin Your Healthcare Your Way!

Check out how more information on insurance in our new book, Easy Healthcare: Choose Your Health Insurance.

The post Can You Read Your Health Insurance Statement? appeared first on MyHealthSpin.