Tips to Prevent Receiving an Unexpected Large Hospital Bill

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Financial debt is a devastating problem in the U.S. that can cause a domino effect of other financial problems, such as credit card debt, bad credit and sometimes even personal bankruptcy. Receiving an unexpected large hospital bill in the mail can lead you into financial debt quickly. As a consumer you can take steps toward lowering those large hospital bills and prevent any unnecessary stress. These steps will help to ensure you are receiving True and Accurate charges and Fair and Reasonable prices on your medical bills.


Contact Your Insurance Provider

Before you go to a hospital, if at all possible, check with your health insurance company to inquire as to whether the medical services and products that you require are covered by your health insurance plan. If there are services that are not covered, find out why and ask if there are any exceptions to have them covered. Confirm that these services are covered by an in-network and out-of-network provider. Please remember insurance usually pays more when you go to an in-network facility or provider.


Prevention of Medical Issues

Although it is not always possible to avoid certain medical conditions, attempting to maintain good health through preventative healthcare is always a good practice. Get checkups regularly, maintain a healthy weight by eating a balanced diet, and strive to stay physically active. With regular checkups and screenings, you provide doctors the opportunity to catch a health issue before it gets complicated, which can save you a lot of money in the long run. Preventing medical issues before they require costly hospital treatment is the best scenario whenever possible.


Choose Your Hospital Wisely

medical-billing-advocate_175670765Did you know that different hospitals charge different amounts for the same or similar services? Because there is a wide price variation in rates between hospitals, even within the same city or area, research to find out which local hospital has the most affordable pricing for the services that you require. If you live in a large city, it’s possible that you will have more choices than a smaller town. Take the time to comparison shop whenever possible. Because you cannot always plan ahead for a trip to a hospital, this tip applies to when it is not a life-threatening or unexpected medical visit.

Hospital pricing can be found online more often today than it could just a few years ago. This is partially due to the media and to health advocates who have pushed hospitals and healthcare clinics to provide transparent pricing for consumers, so that they are aware of costs beforehand. Additionally, pricing transparency makes for good competition between hospitals. You can check prices using an online search engine, as there are cost comparison tools available online, such as Healthcare Bluebook, that provide you with updated prices.

Once you find the lowest price, make sure that your health insurance will cover any predetermined services that you might receive. Many U.S. hospitals have pre-arranged agreements with certain health insurance companies. Unfortunately, if your provider doesn’t have an agreement with the particular hospital you’re planning to attend, you may be responsible for a higher amount. In this case, it is likely more affordable to seek out a hospital that accepts your health insurance carrier.


Get Authorization Beforehand

For some medical procedures and medications, your health insurance plan may require pre-authorization from your doctor before paying for those particular products and services. Your doctor’s office must provide a valid reason for the necessity of the medication or procedure that your health insurance provider will accept. You might also want to plan ahead to obtain pre-authorization whenever possible for any medications the doctor might prescribe after your procedure is performed.


Document Your Hospital Stay

medical-billing-advocate_150829160This tip is for when you are in the hospital, whether it is a short day, an overnight visit or an extended stay. Whenever you have to be admitted to a hospital, take detailed medical notes on your stay there. Document the time you were admitted to a room, time of discharge, what services were administered, when those services were received, what medications you were given, the date and time of administration and the name of the person who administered them. Keep this information for your records to compare to your bill when you receive it.

The purpose of keeping detailed medical records for every hospital stay is to help make sure the hospital bill that you later receive does not have any errors within it. Common billing errors for U.S. consumers include double billing, being charged for services not administered, and being charged for medications that you never received.

In addition, if you were discharged from your hospital room early in the day, as shown by your recorded notes, you may be able to dispute a hospital bill that charges you for a full day room rate. Verify the times you were admitted and discharged to ensure the accuracy of the daily room charges.

While it is not always possible to plan ahead for a hospital visit or to prevent a particular health issue, there are some money-saving actions that you can take beforehand in many situations. The above-noted tips will help you and other consumers to avoid receiving large hospital bills containing errors.

When you are able to reduce the money owed for healthcare, you also reduce a host of other financial issues. If you receive a hospital bill that contains questionable charges, contact a medical billing advocate to be assured you are only receiving True and Accurate charges and Fair and Reasonable pricing.

Filed under: Resources, US Healthcare, Medical Debt, Medical Billing Industry, MBAA Education Center, Consumer Section

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