Health Insurance Today Hospital Billing And The Ub-04 Test Question Is Your Insurance Company Paying Your Medical Bills? Make Sure They Do

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Is Your Insurance Company Paying Your Medical Bills? Make Sure They Do

Medical insurance companies don’t like paying your medical bills, believe it or not. You really need to pay attention to every bill you receive and what the insurance company pays. This can be a daunting task. If you have a lot of bills coming up, you might be experiencing some scary medical issues so you’re not at the top of your game.

I have great sympathy for anyone who is sick, and especially the elderly, who may not have anyone to help them. It’s a lonely feeling once you come home from a hospital stay and you have a life to live. You’re not fully recovered, you may feel sick or experience pain, and the bills that start flooding your mailbox aren’t going to make you feel better.

If you have to spend any time in the hospital, you understand that the bills never end. You pay the hospital, the doctors; you pay for tests, x-rays, radiologists, ugly brown footies, etc. You think you have a handle on it, and then another bill shows up from a company you’ve never heard of.

Since you are the weakest, it is easy to ignore that stack of bills. Insurance companies will use this to their advantage. When my second child was born, I had complications and had to be hospitalized again when he was three weeks old. So on top of the bills from the birth, came a second set for another hospital stay – including the hospital, the doctors, the tests, the radiologists, and the ugly brown footies. It’s too big. And I understand it. For those who haven’t, I imagine it can be brain numbing.

So what can you do? First of all, try your best to stay organized. You can get a ton of bills and it’s a good idea to know where they’re coming from. You see, when you spend time in the hospital, there are payments from everyone, and for everyone. You get the hospital bill, of course, and your own doctor’s bill; any specialist comes to your room to see you within two minutes, all the tests are done – lab work and more expensive exams, like a CT scan, for example. You pay for the radiologist to read, or interpret, the scan, and you pay for the technologist to actually perform the exam. Maybe an anesthesiologist if you have surgery; casts and bandages; prescription drugs that you bring home. And yes, those darn footies – you’d think they’d be glad to get rid of those damn things.

Your insurance company sends you what’s called an EOB, or Explanation of Benefits. This is a form that tells you how much you were charged for a particular service, including doctors’ fees and tests; plus how much the insurance company is obligated to pay based on the contract they have with the service provider, and finally, the amount you have to pay.

All you need to do is match the bill from the EOB service provider to see if they agree. Here’s something that throws people off all the time. It is now very common for hospitals to contract with various types of medical specialists, including radiologists, surgeons, orthopedic physicians, obstetricians, and any other type of specialist you can think of. These doctors have a private practice where they perform outpatient services. They also have a contract with a hospital where they provide the doctor’s services in exchange for having exclusive rights to the hospital.

Let’s say for example, you have a CT scan. If you have a scan while you’re staying in the hospital, they’ll bill you for the exam itself, and you’ll get another bill from the radiologist’s private practice for the interpretation services they perform.

If you have a CT scan in a private practice, you will only see one bill because the radiologist provides the facility and the interpretation.

Know your benefits, keep your bills organized, and question anything the insurance company is doing that you feel is not right. If you think a bill should be paid, ask for it. Your bills can slip through the cracks and go unpaid if you don’t stay on top of them. Medical providers don’t care if you have insurance. Ultimately, it’s your responsibility to pay the bill, so make sure your insurance pays what it owes.

I have wasted hours on the phone with insurance companies explaining to them why they have to pay a particular rate. They don’t argue. I have behind me the knowledge of over 20 years in the medical and insurance industry.

Every time you talk to someone at your insurance company, take notes – time, date, and who you talked to, plus all the important details. Keep everything in one file – an accordion file with alphabetic spaces is fine. Unfortunately, there are times when you have to discuss paying the same bill more than once.

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