10 Ways to Avoid Medical Debt

Medical bills and health insurance are often tedioushospital can provide them. If you still have
and difficult to understand. Healthcare reform isquestions about your coverage, call your insurance
making its way through the Senate but healthcarecompany and ask a representative to explain it.
costs are still rising. As a patient it is time toRemember that your insurance company, not
become your own patient advocate.your doctor, makes decisions about what will be
Maya Jinwright of Washington, DC, a medical billingcovered and what will not.
manager who has worked in hospitals and6. Make sure your insurance company has paid all
doctor's offices, haggles over fees for patientsbills correctly
without insurance. Jinwright often negotiates withOnce you have seen your physician allow 2-4
the hospital and physicians before patients beginweeks for the insurance company to process the
treatment. She explains, "If a patient cannotclaim. It sometimes helps to follow-up with the
afford to pay an insurance premium, they cannotbilling person in your provider's office to make
afford to pay the uninsured treatment charges.sure they have the correct insurance company
Most providers will work with me." In some casesand policy number on file. This simple oversight
the discount can be as large as 60 percent, whichcan cause claims to be denied unnecessarily. When
is in line with what a major insurance companythe claim is processed your insurance company
would have paid.will send you a notice of payment called an
Use these ten tips to ensure you do not becomeexplanation of benefits (often called an EOB). This
a victim of medical debt.notice shows what your insurance company paid,
1. Obtain health insurancewhat your provider's office billed and what you
Health insurance premiums are at an all time high.are responsible to pay as the patient. If your
However, the amount that an elective surgery willinsurance company did not pay an item contact
cost out of pocket is much higher. "Patients oftenthem immediately for details and start the appeals
have no idea that medical expenses tend to beprocess. Most claims submitted are not paid on
exorbitant," says Tara Robertson, medical debtthe first try. Subsequently most appealed claims
consultant at Full Cycle Medical Management aare paid. Contact your provider for assistance
health care consultant firm. Insurance companieswith the appeal or if you need medical records.
have the luxury of contract adjustments to7. Be diligent with your insurance company and
reduce medical bills by as much as 70 percent.provider's office
But, she says, the average uninsured patient doesIf you decide to submit an appeal, mail it via
not get this discount. "It's just not something thatcertified mail or keep the fax confirmation for
most physicians or hospitals explain," Robertsonyour records. Allow 2-4 weeks before calling to
says.check on the status of your appeal. Be sure to
If your employer does not provide insurance ortake note of the insurance representative's name,
you are unable to afford the monthly premiums,date and time of the call. Enlist the help of your
you may be eligible for Medicaid. Generally seniors,provider's office. Most physicians have full time
disabled individuals, children and parent ofbilling staff that can submit appeals. They can
dependent children are eligible for Medicaid if theyprovide additional information and pointers.
have low incomes. Often patients with largeSometimes your insurance carrier will request
medical bills can qualify for temporary Medicaid oradditional information from you or your provider.
medical bill assistance.Complete the forms they send and return them
2. Choose the plan that is right for youimmediately. If you have dependents in college
There are several choices when it comes toyou will need to show proof of enrollment every
health insurance; Indemnity, PPO, or HMO plan:semester. If you have a primary insurance and a
With indemnity coverage, the beneficiary pays asecondary insurance you are asked to complete
portion of costs and the insurance company payscoordination of benefit elections annually.
the rest. Most plans today are HMO (health8. Pay your medical bills in a timely manner
maintenance organization) or PPO (preferredFor most insured patients co-pays are paid as
provider organization) managed care plans. Withsoon as you arrive at the doctor's office or
these plans, the beneficiary pays a co-paymenthospital. Co-insurance and deductibles are
for medical care visits and has an annualcalculated after the visit based on the services
deductible for certain expenses. Be sure yourprovided. Most providers bill on a 30, 60 or 90 day
preferred physicians are in the plan's network, orschedule. Balances left unpaid after 90 days are
you might pay higher out of pocket expenses andoften turned over to a collection agency. When
co-payments.this happens you may be subject to additional
Beware of high-deductible plans. Beneficiaries carryfees, late charges and even refusal of treatment.
a higher amount of financial risk in exchange forIf you are unable to pay the amount that you
much lower monthly premiums. In short if youowe request a payment plan. Ignoring the medical
cannot afford to pay the deductible, this isbill will not make it go away.
probably not the right plan for you.9. Do not be afraid to negotiate
To help choose a plan, calculate total monthlyAs your own patient advocate, be direct. Request
premiums for the year, plus total co-paymentsto speak to the billing supervisor or manager in
and out-of-pocket expenses for the family'sprivate. Then, be clear and confident. Say
health care visits and prescription medications.something like, "These bills are very expensive.
Then look at what one ER visit and one surgeryWould you consider adjusting the patient
(or whatever possibility might befall your family)responsibility to be more affordable?" Or "My
would cost with each plan. Also consider theinsurance isn't covering much of the billed amount,
lifetime maximum -- a serious illness could exceedso I am paying out of pocket for care. Is it
a $1 million or $2 million lifetime maximum. Inpossible to lower the price?" Discussing this
addition, consider how often you see the doctormatter with the billing staff is best, asking your
and if you have the need to see a providerphysician is the wrong way to go. Physicians see
outside of your local area.hundreds of patients. Their focus is patient care
3. Take advantage of a flexible savings accountnot finance. Rest assured that any discounts are
A flexible spending account (also known as anapproved by the physician but asking your doctor
FSA) is a tax-benefited account that allowsto discount your bill in the middle of an office visit
employees to be reimbursed for medical andis not appropriate.
dental expenses on a pre-tax basis. If yourOffering to pay the balance in full immediately in
employer offers an FSA, calculate yourexchange for a discount usually works well. The
anticipated annual expenditures to select an annualoffice normally incurs fees if they have to send
amount that will maximize your tax benefit. Then,the account to a collection agency to recoup so
track your expenses and keep organized records,providing you a discount is usually easier.
this will ensure that you obtain reimbursement forAsk around to see if you qualify for any financial
your expenses.assistance programs. There are often medical
4. Have a yearly physicalfoundations and even medical studies that your
Medical profits are not made on healthy individuals.medical condition or expenses might qualify.
Yearly check-ups, a healthy diet and exercise canIn order to negotiate the best possible deal, do
stave off a number of health issues. Check yoursome research. Sites such as the Healthcare Blue
insurance carrier's website, most carriers offerBook, Vimo, and New Choice Health make
wellness programs and free preventive care.research a piece of cake. With a 20 minute visit
Typical wellness programs provide patients ato these websites, you can find out how much
personalized health report. The programs oftenlocal hospitals and doctors charge. In addition, you
provide educational materials, weight-loss supportcan see the types of discounts insurance
groups, fitness classes, a smoking cessationcompanies receive.
program and personal counseling sessions. Patients10. Ask a professional for help if you are in over
who participate in these free programs are moreyour head
likely to have lower health care costs, fewer sickIf the provider or facility will not give you a
days and be more satisfied individuals. Preventivediscount or you are overwhelmed by your
medicine focuses on health issues that "drive a lotmedical bills, enlist the help of a professional. Full
of costs and can lead to costly medical care like;Cycle Medical Management has specialists who
obesity, smoking and stress.negotiate a reduction on your behalf. Typically the
5. Understand your health insurance plan, beinitial consultation is free and the company charges
informeda fee based on the medical bills that you owe. In
Take the time to read your insurance policy. As aaddition the company provides free one-on-one
patient it is your responsibility to know what yourcoaching, including how to complete and appeal,
insurance company will pay for before younegotiating with your physician's office and/or
receive a service, get tested or fill a prescription.hospital. There is even an online form that you
Some services may have to be approved bycan complete to have a consultant contact you.
your insurance company before your doctor or