Here’s What To Do When You’re Facing A Large Medical Bill

Step 1: Don't panic.

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Getting a large medical bill can be a daunting experience. You’re already dealing with whatever brought you to the doctor or the hospital in the first place, but now you have a huge sum of money to pay. Even if you have insurance, it’s easy to get left with an extremely large medical bill based on deductibles and out-of-pocket costs, and figuring out what to do once you’ve received it can be overwhelming.

Instead of ignoring it and throwing it under a pile of other paperwork, you’ll want to approach paying off your medical bill head on. There are a number of things you can do to make addressing the bill easier, and sometimes, you may even be able to get the amount reduced. I spoke to Sarah O’Leary, Founder and CEO of healthcare advocates Exhale Health, to help you figure out exactly what to do when you’re faced with a large medical bill.

First, O’Leary says, don’t panic.

“Medical bills are typically inflated and often arrive at your doorstep long before the insurance company has ruled on your claim,” O’Leary says.

Second, she advises not to pay it right away.

“Wait to see what the insurance company is going to pay, and wait for the healthcare provider to send you a revised bill,” she says.

Once you’ve received an accurate bill, follow the below steps:

1. Study Your Insurance Policy

Make sure you aware of your insurance policy to ensure that your insurer has paid everything it owes on the claim.

2. Ask for an Itemized Bill

“Ask for an itemized bill from the healthcare provider, including medical billing codes, so that you can check it against the insurer’s claim ruling (known as the Explanation of Benefits or EOB),” O’Leary says.

3. Ask For An Internal Audit

Ask both the insurer and the medical biller for a internal audit of your bill to check for errors.

“Carefully check the medical bill to make certain you received all of the items listed, and that the codes are correct,” she says. According to O’Leary, 50-80 percent of all medical bills contain errors.

4. Check Competitive Prices

Visit healthcarebluebook.com to see if the charges that the healthcare provider is charging you are competitively priced.

“If not, fight the inflated costs,” O’Leary says.

5. Fight Denied Claims

“If the insurance company has denied a claim, ask why,” she says. “If it is not correct, fight it. Sometimes the healthcare provider miscoded the bill, leading to the claim denial.  Make sure you check for that.” According to O’Leary, most claim denials—over 50 percent—are overturned after the first appeal.

6. Ask To Pay In Cash And Set Up A Payment Plan

“Once you know the bill is correct and you’ve received your full coverage, ask if you can lower the bill by paying cash,” says O’Leary. “If you can’t pay cash, ask for a monthly payment system.” Most hospitals and other medical providers are very accommodating to patients paying in monthly installments. So don’t feel like you have to pay off your bill all at once.

7. Turn To An Independent Healthcare Advocate

If you find that your bill is still too high, consider hiring an independent healthcare advocate to help you lower the bill, especially if it’s over $2,000. “They will save you thousands and cost you 25 percent of what they save you,” says O’Leary. “Chances are, that will be significantly better than you can do on your own.”

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