As patient advocates, we get frequent calls from clients about how to determine if their medical billing is correct, or how to deal with denials from their health insurance. Prior to COID-19 medical bills had well over an 80% chance of containing errors, some might even say that number was closer to 90% https://www.beckershospitalreview.com/finance/nearly-90-of-hospital-bills-contain-errors-study-finds.html.
We know that when an individual gets medical bills that are outside of what they expected or denied coverage it adds stress to them and delays their health recovery.
Tips to Reviewing Medical Bills
Here are three tips you can do, to help determine if there may have been a billing or medical mistake in your care.
- When you get your medical bill from your provider, be sure you get your Explanation Of Benefits (EOB) from your insurance company before you pay.
- Request a detailed medical bill from your provider. This will give you exactly what they submitted to your insurance company for reimbursement. Detailed medical bills are only supplied upon request from providers or healthcare organizations.
- Once you have your itemized bills and EOB’s, compare all for missing charges, duplicate charges, or inappropriate items/charges. Also, look to be sure the money paid by the insurance is the same as the payment received by the provider.
If you are dealing with a denial from your insurance, you may request that your provider review and resubmit the claim if there is missing information to your insurance company.
As patient advocates, we know that this process can be very overwhelming and time-consuming. At this point, you may want to consult with a patient advocate that is experienced in medical billing and medical errors.