A Wellness Strategy Might Help Keep Healthcare Costs Low

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Heavy debtBenjamin Franklin once said, “An ounce of prevention is worth a pound of cure”. This statement is true in so many ways, and this idea could help keep healthcare costs low for many individuals. It’s always better to take good care of ourselves so that we might avoid health ailments in the future. The cost of prevention is almost always less of a financial burden than the cure. Likewise, taking steps to keep your healthcare costs low before you need to have services done can help save you a lot of money.

When you know that you will need to have a procedure done and you have health insurance, contact your insurance provider to ensure that the physician and the facility performing the procedure are in your insurance network. It’s not unusual for your physician to refer you to someone else to have a procedure done if it’s not part of his or her field of specialty. Even though your physician might be in your network, don’t assume that who he or she refers you to is also in-network. Additionally, don’t assume that because the facility being used is in-network that all staff in that institution are also in-network. It’s becoming alarmingly common for facilities to use physicians and other specialties who do not participate in your network. Find out who will be performing your procedure ahead of time and make sure they are in your network of covered providers. To further protect yourself, have an appropriate member of administrative staff sign a statement that states only in-network physicians and/or other specialties will be associated with your procedure. This will help protect you from out-of-network providers who could bill you with exorbitant pricing, such as an out-of-network radiologist or anesthesiologist.

It’s always a good practice to have anything stated from the facility in writing, and signed, if possible. For instance, if you get a quote from the facility for the services you are planning to have, make sure that the amount quoted includes all associated services and procedures and that this statement is signed by a member of the administrative staff or a billing office manager. So many times, we see the results of good intentions that have gone bad. A patient will receive a quote from a facility – and sometimes even have an appropriate signature – only to find that the quote was for only the procedure, and did not include charges for the associated physicians and support staff and for the room. Negotiate for a fair price for everything involved in the procedure – from the moment you arrive at the hospital until you leave. Again, make sure this document is signed.

If you do not have the luxury of knowing about a procedure ahead of time, you can still take steps to protect yourself. In an emergency situation, you should try to notate, if possible, all of the items and medications given to you, as well as any services performed. However, you should plan ahead of time for someone else to notate these items, if you are unable to do so. A close friend or family member who would likely be with you during your stay would be the best choice for this job. Once you have requested the detailed, itemized statement of your charges, you can compare the items that you have notated with the items you have been billed. More often than not, you will find that you have been billed for medications, supplies and procedures that you never received. Furthermore, you will likely be billed for items, supplies and services that are non-billable.

Whether a healthcare service has been planned or it was an emergency, it is vital that you request the detailed, itemized statement of the charges. This document should be scrutinized line by line. If you see an item or service that you disagree with or that you are unsure of, question the billing department about it until you receive an answer that you agree with or until the charge has been removed. We live in a time in which it is crucial that we protect ourselves from unfair, inaccurate medical bills. If you would like to learn more about protecting yourself from erroneous charges on your medical bills, contact Medical Billing Advocates of America at 855-203-7058. We are here to help!


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