Summer months for many families include trips to the doctor’s office for annual check-ups and vaccinations. Making sure the family gets the care they need for a fair price is a big responsibility, but with a bit of pre-planning and organization, you can navigate the system successfully. ExHale Health advises clients to take simple steps to avoid unexpected medical charges, and help them resolve billing disputes when they receive “mystery” bills from healthcare providers. Like all successful family endeavors, organization is a must!
1) Read your insurance policy thoroughly. It may not be a fun summer read, but it is really important to understand your family’s coverage before you ever need it. (If you can’t find your policy, most insurers carry plan details on their web sites). Review your plan annually to see if your needs have changed and if another plan might better suit your family.
2) Create a filing system and keep a “hard copy” file for every family member that includes all paperwork you receive from the insurance company (often in the form of an “Explanation of Benefits” document), as well as medical bills from doctors, hospitals or other healthcare providers.
3) Before you have a procedure, check to make sure the doctor, hospital, imaging lab and the procedure itself is approved by your insurance company. Keep track of the approvals for when you receive the bill, and check it for any charges that should have been covered by insurance.
4) If you have an issue with the payment of a claim, the documentation you filed away will help you present a logical argument to the insurer or provider. Oftentimes, hospitals will do “balance billing,” the practice of a healthcare provider billing a patient for the difference between what insurance wants to reimburse and what the provider decides to charge –most moms tend to pay the bill immediately for fear of going to collections, but the secret is you don’t always have to pay it.
5) Don’t overpay for your healthcare! If you receive a bill from a healthcare provider for a medically necessary test or service that should be covered under your insurance, question it. Billing errors, computer “glitches” and other mistakes cost American’s billions of dollars in overpayments every year. Question every cent that you are asked to pay beyond your premium, deductible and co-pays. The insurance company or healthcare provider can make mistakes, but it is up to you to question the bills.
If you don’t contact ExHale Health to help you with your healthcare, we strongly suggest you call someone who has expertise to help you. Friends don’t let friends navigate healthcare alone!
Guest post by Sarah O’Leary, Founder/CEO of ExHale Healthcare Advocates. For more information and tips, please visit the ExHale Healthcare Advocates website at www.ExHaleHealth.com.
(Disclosure: This post was written by someone in the healthcare industry. Making Time For Mommy and the blog’s author are not responsible for claims made by the guest poster.)
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