You might not be able
to control all your health care costs, but scrutiny of your medical bills and
using in-network providers can go a long way to help you save money on your
medical expenses. Health care journalist and author, Lisa Zamoskcy, has an excellent blog on the WebMD
portal called Health Navigator. In her recent blog post she points out that
knowing when and how to take action is the key to saving money on health care.
Here are Lisa’s
recommendations on things every consumer should do.
Always review your medical bills. They’re notoriously
riddled with errors. Be mindful of even minor charges, especially when it comes
to hospital care. For example, one person reported that her grandfather was
alone in the ICU and intubated (had a breathing tube and was unable to speak)
when he was billed for making phone calls at 4 in the morning. Make sure you’re
billed only for the days you were in the hospital, and that there are no
duplicate charges for things such as doctor visits and tests and medicine you
didn’t receive. If you find errors or discrepancies, immediately contact your
doctor’s office manager or billing department, or the hospital where you
Confirm that your insurer paid the provider(s). If doctors or
hospitals fail to bill the insurance company, if they do so improperly and/or
you have more than one type of insurance, confusion can reign. Before paying
anyone, find out if your providers have billed the proper insurance company for
the procedure you received, and then determine how much the insurer paid.
Don’t accept an insurance company’s denial of coverage
without a fight.
“No” doesn’t always mean “no”; sometimes it means “How willing are you to
fight?” Thanks to the national health care reform of 2010, everyone has the
legal right to appeal coverage denials. If the insurance company rules against
you, it must explain why and provide information about how to obtain an
independent review of your case. This right does not apply to grandfathered
health insurance plans, which are explained hereThere’s evidence that appeals
work: The Government Accountability Office (GAO) found that nearly 6 in 10
health insurance appeals were decided in favor of the patient. About 4 in 10
independently reviewed appeals were reversed in the patient’s favor.
Negotiate. Most people are uncomfortable haggling over prices,
whether it’s for heirloom tomatoes at the farmers’ market or health services
from your doctor. But prices for medical care are not rigid. If you need a
break, if you believe the cost is too high and especially if you have a high
deductible or lack insurance altogether, seek financial relief directly from
the source. Your case is stronger if you research in advance fair prices for
the relevant medical service in your area.
Many health insurers have website pricing features. The Healthcare Blue
Book is another pricing resource.
Make sure you are using providers that
are in your insurance network. Using out of network providers can cost you a
lot more in health care expenses. Even
though a PPO plan gives you the freedom to seek care outside of your insurer’s
network, most people understand that doing so costs more money than seeing a
doctor who holds a contract with your health plan, and who has agreed to treat
patients at negotiated rates. You can
check the network status of a doctor or hospital with your insurance company –
most allow you to access their list of providers online or distribute benefit booklets
containing the information – but to be safe, you should call the provider
directly to confirm that they are, indeed, in-network with your insurance
company. The key to receiving care from
a provider that is contracted with your insurance company is in the questions
you ask so be sure you ask the right question, “Are you contracted with my
insurance company, or are you considered an in-network provider?” What
you want to determine is whether the doctor holds a legal contract with your
insurance company that requires him or her to provide medical services at
specific, agreed-upon rates.